Obesity phenotypes in midlife and cognition in early old age The Whitehall II cohort study

作者:Singh Manoux Archana*; Czernichow Sebastien; Elbaz Alexis; Dugravot Aline; Sabia Severine; Hagger Johnson Gareth; Kaffashian Sara; Zins Marie; Brunner Eric J; Nabi Hermann; Kivimaeki Mika
来源:Neurology, 2012, 79(8): 755-762.
DOI:10.1212/WNL.0b013e3182661f63

摘要

Objective: To examine the association of body mass index (BMI) and metabolic status with cognitive function and decline. %26lt;br%26gt;Methods: A total of 6,401 adults (71.2% men), aged 39-63 years in 1991-1993, provided data on BMI (normal weight 18.5-24.9 kg/m(2), overweight 25-29.9 kg/m(2); and obese %26gt;= 30 kg/m(2)) and metabolic status (abnormality defined as 2 or more of 1) triglycerides %26gt;= 1.69 mmol/L or lipid-lowering drugs, 2) systolic blood pressure %26gt;= 130 mm Hg, diastolic blood pressure %26gt;= 85 mm Hg, or antihypertensive drugs, 3) glucose %26gt;= 5.6 mmol/L or medications for diabetes, and 4) high-density lipoprotein cholesterol %26lt;1.04 mmol/L for men and %26lt;1.29 mmol/L for women). Four cognitive tests (memory, reasoning, semantic, and phonemic fluency) were administered in 1997-1999, 2002-2004, and 2007-2009, standardized to z scores, and averaged to yield a global score. %26lt;br%26gt;Results: Of the participants, 31.0% had metabolic abnormalities, 52.7% were normal weight, 38.2% were overweight, and 9.1% were obese. Among the obese, the global cognitive score at baseline (p = 0.82) and decline (p = 0.19) over 10 years was similar in the metabolically normal and abnormal groups. In the metabolically normal group, the 10-year decline in the global cognitive score was similar (p for trend = 0.36) in the normal weight (-0.40; 95% confidence interval [ CI] - 0.42 to -0.38), overweight (-0.42; 95% CI -0.45 to -0.39), and obese (-0.42; 95% CI -0.50 to -0.34) groups. However, in the metabolically abnormal group, the decline on the global score was faster among obese (-0.49; 95% CI -0.55 to -0.42) than among normal weight individuals (-0.42; 95% CI -0.50 to -0.34), (p = 0.03). %26lt;br%26gt;Conclusions: In these analyses the fastest cognitive decline was observed in those with both obesity and metabolic abnormality. Neurology (R) 2012;79:755-762

  • 出版日期2012-8