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Study links nonalcoholic fatty liver disease (NAFLD) to memory impairment, revealing associations with severe liver steatosis and ballooning, along with hippocampal structural and functional abnormalities, emphasizing the need for early cognitive assessment in patients with NAFLD.
The following is a summary of “Presence and Severity of NAFLD are Associated With Cognitive Impairment and Hippocampal Damage,” published in the December 2023 issue of Endocrinology by Miao, et al.
Nonalcoholic fatty liver disease (NAFLD) has been associated with cognitive impairment, but detailed cognitive functions in histologically diagnosed individuals remain poorly understood. For a study, researchers sought to investigate the association between liver pathological changes and cognitive features and explore underlying brain manifestations in individuals with NAFLD.
A cross-sectional study was conducted on 320 subjects who underwent liver biopsy. Among them, 225 underwent assessments of global cognition and cognitive subdomains. Additionally, 70 individuals received functional magnetic resonance imaging scans for neuroimaging evaluations. The associations among liver histological features, brain alterations, and cognitive functions were evaluated using a structural equation model.
Patients with NAFLD, compared to controls, exhibited poorer immediate memory (odds ratio, [OR] 2.189; 95% CI 1.020-4.699) and delayed memory (OR 3.655; 95% CI 1.419-9.414). Severe liver steatosis and ballooning were associated with a higher proportion of memory impairment. Structural magnetic resonance imaging revealed volume loss in the left hippocampus and its subregions (subiculum and presubiculum) in patients with nonalcoholic steatohepatitis. Task-based magnetic resonance imaging showed decreased left hippocampal activation in these patients. Path analysis demonstrated that higher NAFLD activity scores were linked to lower subiculum volume and reduced hippocampal activation, contributing to lower delayed memory scores.
The study was the first to report an association between the presence and severity of NAFLD and an increased risk of memory impairment, along with hippocampal structural and functional abnormalities. The findings underscored the importance of early cognitive evaluation in patients with NAFLD.
Source: academic.oup.com/jcem/article-abstract/108/12/3239/7194802?redirectedFrom=fulltext