Obese teenagers at impaired brain function risk

Researchers at NYU School of Medicine has for the first time revealed that metabolic syndrome (MetS) could cause cognitive and brain impairments in adolescents.

They have urged pediatricians to take this into account when considering the early treatment of childhood obesity.

As childhood obesity has increased in the U.S., so has the prevalence of metabolic syndrome – a constellation of three or more of five defined health problems, including abdominal obesity, low HDL (good cholesterol), high triglycerides, high blood pressure and pre-diabetic insulin resistance.

Lead investigator Antonio Convit, MD, professor of psychiatry and medicine at NYU School of Medicine and a member of the Nathan Kline Research Institute, 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.

Now, the research team has revealed even worse brain impairments in adolescents with metabolic syndrome, a group absent of clinically-manifest vascular disease and likely shorter duration of poor metabolism.

“The prevalence of MetS parallels the rise in childhood obesity,” Dr. Convit said.

“There are huge numbers of people out there who have problems with their weight. If those problems persist long enough, they will lead to the development of MetS and diabetes. As yet, there has been very little information available about what happens to the brain in the setting of obesity and MetS and before diabetes onset in children,” he sttaed.

For the study, the researchers compared 49 adolescents with metabolic syndrome to 62 teens without the disorder. Of those who were not in the MetS group, 40 percent were considered overweight or obese, so while they were not in ideal health, they did not have three out of the five health issues needed to fall into the MetS group. The findings reported, therefore, are conservative and reflective of the real world.

Dr. Convit and colleagues conducted endocrine, MRI and neuropsychological evaluations on the adolescents and found that those classified as having MetS showed significantly lower math and spelling scores, as well as decreased attention span and mental flexibility.

They also showed differences in brain structure and volume, presenting with smaller hippocampal volumes – 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 MetS-characterizing health problems the participants had, the more profound the effect across the board.

“The kids with MetS took longer to do tasks, could not read as well and had poorer math scores. These findings indicate that kids with MetS do not perform well on things that are very relevant to school performance,” Dr. Convit said.

The researchers concluded that even a few years of problems with metabolism might cause brain complications.

The study has been published online in Pediatrics.