Association between Visceral Fat Content and Obesity-Related Indicators with Cognitive Impairment after Intracerebral Hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality, often leading to long-term cognitive impairment that significantly diminishes the quality of life. This study investigated the relationship between visceral fat content, obesity-related indicators, and cognitive dysfunction following ICH. 

Methods: A total of 388 subjects with ICH who were admitted to the Neurosurgery Department of the Hospital and met the inclusion and exclusion criteria were included in this study. Obesity-related indicators, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), were measured. L3 level images were obtained by abdominal computerized tomography (CT). The visceral fat content was estimated using IMAGE J software, and adiponectin levels were assessed via enzyme-linked immunosorbent assay (ELISA). The Mini-Mental State Examination (MMSE) was used to evaluate the cognitive level of patients within 2 weeks of onset, and the shortened version of the Montreal Cognitive Assessment (miniMoCA) was used to evaluate the cognitive level of patients 6 months after ICH. Univariate and multivariate analyses were used to analyze the correlations of BMI, WC, WHtR, abdominal fat, and adiponectin with cognitive impairment after ICH. 

Results: BMI, WC, and WHtR were lower in the cognitive impairment group (p < 0.01). Overweight patients exhibited higher MMSE scores than normal-weight patients (p < 0.05) and higher miniMoCA scores than obese patients (p = 0.014). Abdominal obesity, assessed by WC and WHtR, was associated with higher MMSE scores (p = 0.022 and 0.003, respectively). Multivariate analysis indicated that WHtR was associated with cognitive impairment risk post-ICH (odds ratio (OR) = 0.233, 95% confidence interval (CI) (0.071, 0.762); p = 0.016). Although no overall association was found between adiponectin levels and cognitive impairment, subgroup analysis revealed lower adiponectin levels in overweight patients with cognitive impairment (p = 0.040).  

Conclusion: WHtR is independently and inversely associated with cognitive impairment after ICH. There is no significant correlation between adiponectin with cognitive impairment after ICH, while subgroup analysis indicates that adiponectin levels are lower in overweight patients with cognitive impairment.