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J Neurol Sci. 2014 Oct 15;345(1-2):176-80. doi: 10.1016/j.jns.2014.07.037. Epub 2014 Jul 22.

The effects of cystatin C and alkaline phosphatase changes on cognitive function 12-months after bariatric surgery.

Author information

1
Kent State University, Kent, OH, United States.
2
Weill Cornell Medical College, New York, NY, United States.
3
Columbia University Medical Center, New York, NY, United States.
4
University of Florida Institute on Aging, Gainesville, FL, United States.
5
University of North Dakota School of Medicine and Health Sciences, Neuropsychiatric Research Institute, Fargo, ND, United States.
6
Kent State University, Kent, OH, United States. Electronic address: jgunstad@kent.edu.

Abstract

BACKGROUND:

The mechanisms for improved cognitive function post-bariatric surgery are not well understood. Markers of kidney and liver function (i.e., cystatin C and alkaline phosphatase (ALP)) are elevated in obese individuals and associated with poor neurocognitive outcomes in other samples. Bariatric surgery can improve cystatin C and ALP levels, but no study has examined whether such changes correspond to post-operative cognitive benefits.

METHODS:

78 bariatric surgery patients completed a computerized cognitive test battery prior to and 12-months after surgery. All participants underwent an eight-hour fasting blood draw to quantify cystatin C and ALP concentrations.

RESULTS:

Cognitive function improved after surgery. Cystatin C levels decreased at the 12-month follow-up; however, no changes were found in ALP concentrations. At baseline, higher cystatin C levels predicted worse attention/executive function, but no such effects emerged for ALP. Regression analyses controlling for possible medical and demographic confounds and baseline factors revealed that decreased ALP levels following surgery predicted better attention/executive function and memory abilities. Post-surgery changes in cystatin C did not correspond to cognitive improvements.

CONCLUSIONS:

Decreased ALP levels predicted better cognition following bariatric surgery, suggesting improved liver function as a possible mechanism of post-operative cognitive benefits. Future studies with neuroimaging and longer follow-up periods are needed to determine whether bariatric surgery can decrease risk for adverse brain changes and dementia in severely obese persons via improved metabolic function.

KEYWORDS:

Alkaline phosphatase; Bariatric surgery; Cognitive function; Cystatin C; Metabolic function; Obesity

PMID:
25073570
PMCID:
PMC4178165
DOI:
10.1016/j.jns.2014.07.037
[Indexed for MEDLINE]
Free PMC Article

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