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Metabolic syndrome impairs adolescent brain function
A study by researchers at New York University’s (NYU) School of Medicine has revealed that metabolic syndrome is associated with cognitive and brain impairments in adolescents.
The research, which is published online in the journal Pediatrics, calls for paediatricians to take the condition into account when considering the early treatment of childhood obesity.
"The prevalence of metabolic syndrome parallels the rise in childhood obesity,” said lead investigator Dr Antonio Convit, professor of psychiatry and medicine at NYU School of Medicine and a member of the Nathan Kline Research Institute “There are huge numbers of people out there who have problems with their weight. As yet, there has been very little information available about what happens to the brain in the setting of obesity and metabolic syndrome and before diabetes onset in children.”
Convit and colleagues have shown previously that metabolic syndrome has been linked to neurocognitive impairments in adults, but this association was generally thought to be a long-term effect of poor metabolism. This latest study has shown even more severe brain impairments in adolescents with metabolic syndrome, a group absent of clinically-manifest vascular disease and likely shorter duration of poor metabolism.
For the study, the researchers compared 49 adolescents with metabolic syndrome to 62 teens without the disorder. The groups were balanced according to age, socioeconomic status, school grade, gender and ethnicity to ensure aspectslike cultural differences in diet and access to quality healthcare did not cloud the data.
Forty percent of patients without metabolic syndrome were considered overweight or obese.
The researchers conducted endocrine, MRI and neuropsychological evaluations on the adolescents and found that those classified as having metabolic syndrome showed significantly lower math and spelling scores, as well as decreased attention span and mental flexibility (performing between 5% and 15% worse than those without metabolic syndrome).
The overweight and obese patients also showed differences in brain structure and volume, presenting with smaller hippocampal volumes, which is involved in the learning and recall of new information, increased brain cerebrospinal fluid and reductions of microstructural integrity in major white matter tracts in the brain.
The more metabolic syndrome criteria the participants had, the more profound the effect on brain function.
“The kids with metabolic syndrome took longer to do tasks, could not read as well and had poorer math scores,” said Convit said. “These findings indicate that kids with metabolic syndrome do not perform well on things that are very relevant to school performance.”
The researchers concluded that even a few years of problems with metabolism may cause brain complications. They suggest the adverse impact of metabolic syndrome on brain function in children could be used by paediatricians as a powerful motivator to get families more involved in meaningful lifestyle change.
"Many paediatricians don't even take a blood pressure, and they certainly are not taking cholesterol levels and testing insulin resistance,” he added. “Parents need to understand that obesity has medical consequences, even in children, and some of those consequences may be impacting more than just the long term health of the cardiovascular system.”
Future research is needed to determine whether the reductions in cognitive performance and structural brain abnormalities are reversible with significant weight loss.
“The take home message is that just being overweight and obese is already impacting your brain,” said Convit. “Simple changes in daily routine could prevent metabolic syndrome and if we can help one kid not become diabetic, that's one kid's life we've saved.”