Alteration of cognitive function in overweight and obese adolescents and its relationship with serum FGF21 levels

doi:10.3969/j.issn.1674-8115.2024.01.010

Abstract

Abstract:

Objective ·To evaluate the changes in cognitive function in overweight and obese adolescents, and explore the association between cognitive function and fibroblast growth factor 21 (FGF21). Methods ·A total of 175 adolescents from a senior high school in Shanghai were divided into normal weight group (n=50), overweight group (n=50) and obese group (n=75) based on their body mass index (BMI). General information, anthropometric data and laboratory testing indicators of the adolescents were collected and compared. The cognitive function of the three groups of adolescents was assessed by using the accuracy (ACC) and reaction time of Flanker task and n-back task. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum FGF21 level of the three groups of adolescents. Partial correlation analysis and multiple linear regression model were used to evaluate the correlation between cognitive task performance and anthropometric data and laboratory testing indicators. Results ·Compared with the normal weight group, systolic blood pressure, diastolic blood pressure, and the levels of fasting plasma glucose, glycosylated hemoglobin and triacylglycerol in the obese group were higher (all P<0.05). Under congruent or incongruent stimulus conditions in the Flanker task, there was no significant difference in ACC between any two groups; compared with the normal weight and overweight groups, the reaction time of the adolescents in the obese group was prolonged (all P<0.05). In the n-back task, there were no significant differences in ACC between any two groups, while the obese group had longer reaction time in the 1-back and 2-back tasks compared to the normal weight and overweight groups (all P<0.05). Compared with the normal weight group, serum FGF21 levels of the adolescents in the obese group were higher (P=0.000). Partial correlation analysis showed that the reaction time of the adolescents in Flanker and n-back tasks was correlated with their BMI, body fat mass, waist circumference, waist-to-hip ratio and FGF21 level (all P<0.05). Multiple linear regression analysis further confirmed that BMI was associated with prolonged reaction time in cognitive-related behavioral tasks in the adolescents (all P<0.05), and FGF21 level was associated with ACC in the 2-back task (P=0.000) and reaction time in the incongruent stimulus condition (P=0.048). Conclusion ·Overweight and obese adolescents have cognitive impairments, and BMI and serum FGF21 levels are associated with changes in their cognitive function.

Key words: obese adolescent, cognitive function, behavioral experiment, fibroblast growth factor 21 (FGF21)

CLC Number:

R589

HAN Rui, WU Qian, LIU Dan, CHENG Di, ZHANG Ying, NI Jiacheng, KANG Piao, CHEN Anran, YU Shujie, FANG Qichen, LI Huating. Alteration of cognitive function in overweight and obese adolescents and its relationship with serum FGF21 levels[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(1): 87-97.

Figures/Tables 8

TrendMD

References 28

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Item	Normal weight group (n=50)	Overweight group (n=50)	Obese group (n=75)	P value
General information
Age/year	15.18 ± 0.48	15.52 ± 0.58	15.31 ± 0.52	0.327
Gender (male/female)/n	29/21	30/20	50/25	0.117
BMI/(kg·m^-2)	21.35 ± 2.16	25.26 ± 0.98^*	30.37 ± 2.73^*#	0.000
Body fat mass/kg	12.73 ± 4.90	20.91 ± 4.69^*	29.95 ± 6.62^*#	0.000
Body fat percentage/%	20.93 ± 7.73	28.47 ± 7.21^*	33.55 ± 5.83^*#	0.000
Waist circumference/cm	73.95 ± 7.48	82.87 ± 3.69^*	95.53 ± 9.14^*#	0.000
Hip circumference/cm	94.70 ± 5.77	103.71 ± 3.80^*	110.09 ± 5.38^*#	0.000
Waist-to-hip ratio	0.80 ± 0.04	0.84 ± 0.01^*	0.89 ± 0.03^*#	0.000
SBP/mmHg	115.04 ± 12.27	120.29 ± 11.51	124.39 ± 9.98^*	0.000
DBP/mmHg	63.84 ± 7.42	69.09 ± 8.73^*	70.44 ± 9.27^*	0.000
Laboratory testing indicator
FPG/(mmol·L^-1)	4.62 ± 0.35	4.78 ± 0.30	4.79 ± 0.37^*	0.014
FINS/(mmol·L^-1)	15.03 (11.43, 19.28)	21.67 (17.62, 29.76)^*	29.94 (18.96, 38.32)^*#	0.000
HbA1c/%	5.31 ± 0.21	5.32 ± 0.16	5.42 ± 0.27^*	0.008
Scr/(µmol·L^-1)	65.95 (58.40, 76.85)	66.25 (56.33, 73.83)^*	71.90 (63.50, 79.50)^{* #}	0.052
UA/(µmol·L^-1)	368.86 ± 85.19	397.66 ± 82.31	451.24 ± 102.53^*	0.000
ALT/(U·L^-1)	14.00 (11.00, 17.25)	17.50 (15.00, 27.00)^*	26.00 (20.00, 48.00)^*#	0.000
AST/(U·L^-1)	21.00 (17.75, 24.00)	21.00 (18.00, 26.25)	26.00 (20.00, 32.00)^*	0.000
GGT/(U·L^-1)	16.50 (14.00, 21.00)	19.50 (14.75, 25.00)	23.00 (17.00, 32.00)^*#	0.000
TC/(mmol·L^-1)	4.36 ± 0.78	4.30 ± 0.76^*	4.33 ± 0.74^*#	0.880
TAG/(mmol·L^-1)	0.74 (0.55, 1.04)	0.87 (0.61, 1.29)	0.92 (0.69, 1.37)	0.012
HDL-Ch/(mmol·L^-1)	1.44 ± 0.29	1.26 ± 0.26^*	1.21 ± 0.25^*	0.000
LDL-Ch/(mmol·L^-1)	2.48 ± 0.70	2.56 ± 0.56	2.69 ± 0.69	0.076

Item	Normal weight group (n=50)	Overweight group (n=50)	Obese group (n=75)	P value
General information
Age/year	15.18 ± 0.48	15.52 ± 0.58	15.31 ± 0.52	0.327
Gender (male/female)/n	29/21	30/20	50/25	0.117
BMI/(kg·m^-2)	21.35 ± 2.16	25.26 ± 0.98^*	30.37 ± 2.73^*#	0.000
Body fat mass/kg	12.73 ± 4.90	20.91 ± 4.69^*	29.95 ± 6.62^*#	0.000
Body fat percentage/%	20.93 ± 7.73	28.47 ± 7.21^*	33.55 ± 5.83^*#	0.000
Waist circumference/cm	73.95 ± 7.48	82.87 ± 3.69^*	95.53 ± 9.14^*#	0.000
Hip circumference/cm	94.70 ± 5.77	103.71 ± 3.80^*	110.09 ± 5.38^*#	0.000
Waist-to-hip ratio	0.80 ± 0.04	0.84 ± 0.01^*	0.89 ± 0.03^*#	0.000
SBP/mmHg	115.04 ± 12.27	120.29 ± 11.51	124.39 ± 9.98^*	0.000
DBP/mmHg	63.84 ± 7.42	69.09 ± 8.73^*	70.44 ± 9.27^*	0.000
Laboratory testing indicator
FPG/(mmol·L^-1)	4.62 ± 0.35	4.78 ± 0.30	4.79 ± 0.37^*	0.014
FINS/(mmol·L^-1)	15.03 (11.43, 19.28)	21.67 (17.62, 29.76)^*	29.94 (18.96, 38.32)^*#	0.000
HbA1c/%	5.31 ± 0.21	5.32 ± 0.16	5.42 ± 0.27^*	0.008
Scr/(µmol·L^-1)	65.95 (58.40, 76.85)	66.25 (56.33, 73.83)^*	71.90 (63.50, 79.50)^{* #}	0.052
UA/(µmol·L^-1)	368.86 ± 85.19	397.66 ± 82.31	451.24 ± 102.53^*	0.000
ALT/(U·L^-1)	14.00 (11.00, 17.25)	17.50 (15.00, 27.00)^*	26.00 (20.00, 48.00)^*#	0.000
AST/(U·L^-1)	21.00 (17.75, 24.00)	21.00 (18.00, 26.25)	26.00 (20.00, 32.00)^*	0.000
GGT/(U·L^-1)	16.50 (14.00, 21.00)	19.50 (14.75, 25.00)	23.00 (17.00, 32.00)^*#	0.000
TC/(mmol·L^-1)	4.36 ± 0.78	4.30 ± 0.76^*	4.33 ± 0.74^*#	0.880
TAG/(mmol·L^-1)	0.74 (0.55, 1.04)	0.87 (0.61, 1.29)	0.92 (0.69, 1.37)	0.012
HDL-Ch/(mmol·L^-1)	1.44 ± 0.29	1.26 ± 0.26^*	1.21 ± 0.25^*	0.000
LDL-Ch/(mmol·L^-1)	2.48 ± 0.70	2.56 ± 0.56	2.69 ± 0.69	0.076

Item	Normal weight group (n=50)	Overweight group (n=50)	Obese group (n=75)	P value
Flanker task
ACC
Congruent stimulus	0.97 ± 0.09	0.97 ± 0.04	0.98 ± 0.04	0.442
Incongruent stimulus	0.92 ± 0.09	0.93 ± 0.10	0.92 ± 0.14	0.854
Reaction time/ms
Congruent stimulus	406.12 ± 108.32	431.35 ± 85.17	475.13 ± 84.31	0.000
Incongruent stimulus	465.41 ± 95.59	463.55 ± 59.92	524.01 ± 103.79	0.000
n-back task
ACC
0-back	0.94 ± 0.05	0.93 ± 0.07	0.93 ± 0.08	0.641
1-back	0.84 ± 0.12	0.85 ± 0.08	0.86 ± 0.12	0.404
2-back	0.78 ± 0.13	0.72 ± 0.16	0.78 ± 0.15	0.751
Reaction time/ms
0-back	522.52 ± 103.11	539.48 ± 104.85	564.34 ± 116.74	0.050
1-back	541.76 ± 149.67	587.90 ± 160.04	656.60 ± 168.99	0.000
2-back	570.49 ± 174.48	625.08 ± 199.08	754.24 ± 201.57	0.000

Item	Normal weight group (n=50)	Overweight group (n=50)	Obese group (n=75)	P value
Flanker task
ACC
Congruent stimulus	0.97 ± 0.09	0.97 ± 0.04	0.98 ± 0.04	0.442
Incongruent stimulus	0.92 ± 0.09	0.93 ± 0.10	0.92 ± 0.14	0.854
Reaction time/ms
Congruent stimulus	406.12 ± 108.32	431.35 ± 85.17	475.13 ± 84.31	0.000
Incongruent stimulus	465.41 ± 95.59	463.55 ± 59.92	524.01 ± 103.79	0.000
n-back task
ACC
0-back	0.94 ± 0.05	0.93 ± 0.07	0.93 ± 0.08	0.641
1-back	0.84 ± 0.12	0.85 ± 0.08	0.86 ± 0.12	0.404
2-back	0.78 ± 0.13	0.72 ± 0.16	0.78 ± 0.15	0.751
Reaction time/ms
0-back	522.52 ± 103.11	539.48 ± 104.85	564.34 ± 116.74	0.050
1-back	541.76 ± 149.67	587.90 ± 160.04	656.60 ± 168.99	0.000
2-back	570.49 ± 174.48	625.08 ± 199.08	754.24 ± 201.57	0.000

Item	ACC		Reaction time
Item	Incongruent stimulus	Congruent stimulus	Incongruent stimulus	Congruent stimulus
BMI	-0.004 (0.958)	0.033 (0.678)	0.259 (0.000)	0.337 (0.000)
Body fat mass	0.004 (0.963)	0.014 (0.857)	0.154 (0.045)	0.242 (0.000)
Body fat percentage	-0.013 (0.874)	-0.024 (0.764)	0.061 (0.431)	0.193 (0.011)
Waist-to-hip ratio	0.008 (0.928)	0.054 (0.495)	0.217 (0.004)	0.280 (0.000)
Waist circumference	0.007 (0.930)	-0.018 (0.820)	0.156 (0.042)	0.269 (0.000)
Hip circumference	-0.016 (0.848)	-0.027 (0.731)	0.107 (0.162)	0.238 (0.002)
SBP	0.051 (0.538)	0.006 (0.940)	0.041 (0.596)	0.109 (0.155)
DBP	-0.029 (0.729)	0.034 (0.674)	-0.042 (0.581)	0.058 (0.452)
FINS	-0.053 (0.523)	0.030 (0.707)	0.088 (0.250)	0.132 (0.084)
HbA1c	-0.114 (0.168)	-0.037 (0.639)	0.023 (0.765)	0.110 (0.153)
FPG	0.072 (0.387)	0.012 (0.877)	-0.074 (0.336)	0.032 (0.680)
ALT	-0.105 (0.204)	0.041 (0.607)	0.100 (0.191)	0.142 (0.062)
AST	-0.099 (0.231)	0.069 (0.384)	0.115 (0.133)	0.099 (0.194)
GGT	-0.095 (0.251)	0.057 (0.473)	0.088 (0.251)	0.123 (0.107)
Scr	0.075 (0.363)	0.077 (0.335)	0.219 (0.004)	0.049 (0.521)
UA	-0.067 (0.420)	0.035 (0.662)	0.171 (0.025)	0.139 (0.069)
TC	0.026 (0.755)	-0.053 (0.508)	-0.015 (0.849)	-0.116 (0.130)
TAG	-0.112 (0.177)	-0.113 (0.154)	0.002 (0.975)	-0.003 (0.973)
HDL-Ch	-0.014 (0.863)	0.063 (0.425)	0.014 (0.855)	-0.045 (0.556)
LDL-Ch	0.042 (0.616)	-0.083 (0.293)	-0.005 (0.950)	-0.098 (0.202)