J Clin Neurol.  2015 Jan;11(1):48-56. 10.3988/jcn.2015.11.1.48.

Improved Serum Leptin and Ghrelin Following Bariatric Surgery Predict Better Postoperative Cognitive Function

Affiliations
  • 1Department of Psychology, Kent State University, Kent, OH, USA. jgunstad@kent.edu
  • 2Department of Surgery, Weill Cornell Medical College, New York, NY, USA.
  • 3College of Physician's and Surgeons, Columbia University Medical Center, New York, NY, USA.
  • 4Institute on Aging, Department of Aging & Geriatric Research, University of Florida Institute on Aging, Gainesville, FL, USA.
  • 5Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.

Abstract

BACKGROUND AND PURPOSE
Bariatric surgery is associated with improved cognitive function, but the mechanisms underlying these gains remain poorly understood. Disturbed leptin and ghrelin systems are common in obese individuals and are associated with impaired cognitive function in other samples. Bariatric surgery has been shown to improve serum leptin and ghrelin levels, and these changes may underlie postoperative cognitive improvements.
METHODS
Eighty-four patients completed a computerized cognitive test battery prior to bariatric surgery and at 12 months postoperatively. Participants also submitted to an 8-hour fasting blood draw to quantify serum leptin and ghrelin concentrations at these same time points.
RESULTS
Baseline cognitive impairments and disturbed leptin and ghrelin levels improved at the 12-month follow-up compared to presurgery. Higher leptin levels were associated with worse attention/executive function at baseline; no such findings emerged for ghrelin. Regression analyses controlling for baseline factors and demographic characteristics showed that both decreased leptin and increased ghrelin following surgery was associated with better attention/executive function at the 12-month follow-up. These effects diminished after controlling for the postoperative change in body mass index (BMI); however, BMI change did not predict 12-month cognitive function.
CONCLUSIONS
Improvements in leptin and ghrelin levels following bariatric surgery appear to contribute to postoperative cognitive benefits. These gains may involve multiple mechanisms, such as reduced inflammation and improved glycemic control. Future studies that employ neuroimaging are needed to clarify the underlying mechanisms and determine whether the effects of bariatric surgery on leptin and ghrelin levels can attenuate adverse brain changes and/or risk of dementia in severely obese individuals.

Keyword

obesity; bariatric surgery; cognitive function; leptin; ghrelin

MeSH Terms

Bariatric Surgery*
Body Mass Index
Brain
Dementia
Fasting
Follow-Up Studies
Ghrelin*
Humans
Inflammation
Leptin*
Neuroimaging
Obesity
Ghrelin
Leptin

Cited by  1 articles

Comments on "Improved Serum Leptin and Ghrelin Following Bariatric Surgery Predict better Postoperative Cognitive Function"
Mehmet Agilli, Fevzi Nuri Aydin, Yasemin Gulcan Kurt, Tuncer Cayci
J Clin Neurol. 2015;11(4):402-403.    doi: 10.3988/jcn.2015.11.4.402.


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