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Exp Clin Endocrinol Diabetes 2016; 124(09): 568-571
DOI: 10.1055/s-0042-113125
Article
© Georg Thieme Verlag KG Stuttgart · New York

Antioxidant Enzyme Activity and Cognition in Obese Individuals with or without Metabolic Risk Factors

R. Farah
1   The Department of Internal Medicine B, Ziv Medical Center, Safed, Israel
2   The Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
,
P. Gilbey
2   The Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
,
M. Grozovski
3   Department of Biotechnology Engineering, Ort Braude College, Karmiel, Israel
,
H. Asli
1   The Department of Internal Medicine B, Ziv Medical Center, Safed, Israel
,
R. Khamisy-Farah
2   The Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
4   Clalit Health Service, Women Health Care, Akko, Israel
,
N. Assy
2   The Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
5   Liver Disease Unit, Ziv Medical Center, Safed, Israel
› Author Affiliations
Further Information

Publication History

received 18 May 2016
revised 12 July 2016

accepted 20 July 2016

Publication Date:
22 September 2016 (online)

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Antioxidant Enzyme Activity and Cognition in Obese Individuals with or without Metabolic Risk FactorsExp Clin Endocrinol Diabetes 2016; 124(09): e3-e3
DOI: 10.1055/s-0042-119521

Abstract

Background: The metabolic syndrome may be associated with cognitive impairment and increased oxidative stress.

Aim: To document the association between metabolic syndrome, cognitive impairment and oxidative stress activity in metabolically healthy obese and in metabolically unhealthy obese individuals.

Methods: 60 obese individuals aged (49±10 years, 52% male) were enrolled. Obesity was defined as BMI>30. Metabolic syndrome was defined according to ATP III guidelines. Obese individuals were divided into 2 groups: Group 1, metabolically healthy obese (≤2 components of metabolic syndrome), and Group 2, metabolically unhealthy obese (>2 components of metabolic syndrome). Cognitive dysfunction was determined by Montreal cognitive assessment score. Liver Fibro scan (Elastography), Inflammation (CRP), pro oxidants (MDA), antioxidant activity (SOD, PON, GSH, GPx) and insulin resistance (HOMA-IR) were measured.

Results: Of the 30 metabolically unhealthy obese individuals, 13% developed dementia, 51% had mild cognitive impairment, and 36% had a normal cognitive score. In the metabolically healthy obese group, 3% developed dementia, 7% had mild cognitive impairment, and 90% had a normal cognitive score. There was a significant difference in liver stiffness (7±3 vs. 5.2±2.7 kpa, p<0.001), liver fat measurement (337±51 vs. 280±20 db/m, p<0.001), MDA (4.7±0.9 vs. 5.47±1.12 mM, P<0.003), Glutathione GSH (27.2±2.4 vs. 28.4±2.3, P<0.03), CRP (9±6 vs. 7±6 P<0.001) and insulin resistance (2.5±1 vs. 6±5.5 p<0.02) between the 2 groups. Correlations were significant between GPx activity and liver stiffness (r=0.37), GPx activity and abdominal girth (r=−0.22) and glucose concentration and SOD activity (r=0.4). Multivariate analysis showed that HOMA-IR, MDA and GSH were the most powerful predictors of metabolically unhealthy obesity.

Conclusion: There is a significant mild cognitive impairment and increased oxidative stress activity in the metabolically unhealthy obese. Whether treatment with anti-oxidants improves cognitive dysfunction remains to be determined.

Key words

antioxidant - metabolic syndrome - healthy individuals - unhealthy - cognition - liver fibro scan
 

  • References

  • 1 Luppino FS, de Wit LM, Bouvy PF et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220-229
    Search in Google Scholar
  • 2 Istvan J, Zavela K, Weidner G. Bodyweight and psychological distress in NHANES I. Int J Obes Relat Metab Disord 1992; 16: 999-10033
    PubMedSearch in Google Scholar
  • 3 Crisp AH, McGuiness B. Jolly fat: relation between obesity and psychoneurosis in general population. BMJ 1976; 1: 7-9
    CrossrefPubMedSearch in Google Scholar
  • 4 Magnusson PK, Rasmussen F, Lawlor DA et al. Association of body mass index with suicide mortality: a prospective cohort study of more than one million men. Am J Epidemiol 2006; 163: 1-8
    CrossrefPubMedSearch in Google Scholar
  • 5 Blüher M. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. Curr Opin Lipidol 2010; 21: 38-43
    CrossrefPubMedSearch in Google Scholar
  • 6 Wildman RP, Muntner P, Reynolds K et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004). Arch Intern Med 2008; 168: 1617-1624
    CrossrefPubMedSearch in Google Scholar
  • 7 Kilpeläinen TO, Zillikens MC, Stančákova A et al. Genetic variation near IRS1 associates with reduced adiposity and an impaired metabolic profile. Nat Genet 2011; 43: 753-760
    CrossrefPubMedSearch in Google Scholar
  • 8 Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 635-643
    CrossrefPubMedSearch in Google Scholar
  • 9 Whitlock G, Lewington S, Sherliker P. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083-1096
    CrossrefPubMedSearch in Google Scholar
  • 10 Katzmarzyk PT, Janssen I, Ross R et al. The importance of waist circumference in the definition of metabolic syndrome: prospective analyses of mortality in men. Diabetes Care 2006; 29: 404-409
    CrossrefPubMedSearch in Google Scholar
  • 11 Kip KE, Marroquin OC, Kelley DE et al. Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women: a report from the Women’s Ischemia Syndrome Evaluation (WISE) study. Circulation 2004; 109: 706-713
    CrossrefPubMedSearch in Google Scholar
  • 12 Song Y, Manson JE, Meigs JB et al. Comparison of usefulness of body mass index versus metabolic risk factors in predicting 10-year risk of cardiovascular events in women. Am J Cardiol 2007; 100: 1654-1658
    CrossrefPubMedSearch in Google Scholar
  • 13 Meigs JB, Wilson PW, Fox CS et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 2006; 91: 2906-2912
    CrossrefPubMedSearch in Google Scholar
  • 14 St-Pierre AC, Cantin B, Mauriège P et al. Insulin resistance syndrome, body mass index and the risk of ischemic heart disease. CMAJ 2005; 172: 1301-1305
    CrossrefPubMedSearch in Google Scholar
  • 15 Calori G, Lattuada G, Piemonti L. Prevalence, metabolic features, and prognosis of metabolically healthy obese Italian individuals: the Cremona Study. Diabetes Care 2011; 34: 210-215
    CrossrefPubMedSearch in Google Scholar
  • 16 Arnlöv J, Ingelsson E, Sundström J et al. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation 2010; 121: 230-236
    CrossrefPubMedSearch in Google Scholar
  • 17 Higdon JV, Frei B. Obesity and oxidative stress: a direct link to cardiovascular disease?. Arterioscler Thromb Vasc Biol 2003; 23: 365-367
    CrossrefPubMedSearch in Google Scholar
  • 18 Akbaraly TN, Kivimäki M, Brunner EJ et al. Association between metabolic syndrome and depressive symptoms in middle-aged adults: results from the Whitehall II study. Diabetes Care 2009; 32: 499-504
    CrossrefPubMedSearch in Google Scholar
  • 19 Koponen H, Jokelainen J, Keinänen-Kiukaanniemi S et al. Metabolic syndrome predisposes to depressive symptoms: a population-based 7-year follow-up study. J Clin Psychiatry 2008; 69: 178-182
    CrossrefPubMedSearch in Google Scholar
  • 20 Golden SH, Lazo M, Carnethon M et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA 2008; 299: 2751-2759
    CrossrefPubMedSearch in Google Scholar
  • 21 Gale CR, Kivimaki M, Lawlor DA et al. Fasting glucose, diagnosis of type 2 diabetes, and depression: the Vietnam experience study. Biological Psychiatry 2010; 67: 189-192
    CrossrefPubMedSearch in Google Scholar
  • 22 Kivimäki M, Tabak AG, Batty GD et al. Hyperglycemia, type 2 diabetes, and depressive symptoms: the British Whitehall II study. Diabetes Care 2009; 32: 1867-1869
    CrossrefPubMedSearch in Google Scholar
  • 23 Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009; 71: 171-186
    CrossrefPubMedSearch in Google Scholar
  • 24 Wong GK, Lam SW, Wong A et al. Comparison of montreal cognitive assessment and mini-mental state examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage. PLoS One 2013; 8: e59946
    CrossrefPubMedSearch in Google Scholar
  • 25 Koenigsberg HW, Teicher MH, Mitropoulou V et al. 24-h Monitoring of plasma norepinephrine, MHPG, cortisol, growth hormone and prolactin in depression. J Psych Res 2004; 38: 503-511
    CrossrefPubMedSearch in Google Scholar
  • 26 Licht CM, Vreeburg SA, van Reedt Dortland AK. Increased sympathetic and decreased parasympathetic activity rather than changes in hypothalamic-pituitary-adrenal axis activity is associated with metabolic abnormalities. J Clin Endocrinol Metab 2010; 95: 2458-2466
    CrossrefPubMedSearch in Google Scholar
  • 27 Mancia G, Bousquet P, Elghozi JL et al. The sympathetic nervous system and the metabolic syndrome. J Hypertens 2007; 25: 909-920
    CrossrefPubMedSearch in Google Scholar
  • 28 Trzepacz PT, Hochstetler H, Wang S et al. Alzheimer’s Disease Neuroimaging Initiative . Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults. BMC Geriatr 2015; 15: 107
    CrossrefPubMedSearch in Google Scholar
  • 29 Yaffe K, Kanaya AM, Lindquist K et al. The metabolic syndrome, inflammation, and risk of cognitive decline. JAMA 2004; 292: 2237-2242
    CrossrefPubMedSearch in Google Scholar
  • 30 Razay G, Vreugdenhil A, Wilcock G. The metabolic syndrome and Alzheimer disease. Arch Neurol 2007; 64: 93-96
    CrossrefPubMedSearch in Google Scholar
  • 31 Vanhanen M, Koivisto K, Moilanen L et al. Association of metabolic syndrome with Alzheimer disease: a population-based study. Neurology 2006; 67: 843-847
    CrossrefPubMedSearch in Google Scholar
  • 32 Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol 2005; 4: 487-499
    CrossrefPubMedSearch in Google Scholar
  • 33 Gasparini L, Gouras GK, Wang R et al. Stimulation of β-amyloid precursor protein trafficking by insulin reduces intraneuronal β-amyloid and requires mitogen-activated protein kinase signaling. J Neurosci 2001; 21: 2561-2570
    CrossrefPubMedSearch in Google Scholar
  • 34 Jagust W, Harvey D, Mungas D et al. Central obesity and the aging brain. Arch Neurol 2005; 62: 1545-1548
    PubMedSearch in Google Scholar
  • 35 Dik MG, Jokner C, Comijs HC et al. Contribution of metabolic syndrome components to cognition in older individuals. Diabetes Care 2007; 30: 2655-2660
    CrossrefPubMedSearch in Google Scholar
  • 36 Vincent HK, Taylor AG. Biomarkers and potential mechanisms of obesity induced oxidative stress in humans. International journal of obesity 2006; 30: 400-418
    CrossrefPubMedSearch in Google Scholar