9e88b436963419fc555011f82ae44d38 pmc_31835729.pdf f569bd0ad90804c52d7522da8a4bf5d2e07a30a4 pmc_31835729.pdf e15420c62cd63ffa63bd51649182983ffc2d0560a53476e7c6102dee75689d30 pmc_31835729.pdf Title: Retinal Microperimetry: A Useful Tool for Detecting Insulin Resistance-Related Cognitive Impairment in Morbid Obesity Subject: Background: There is clear association between type 2 diabetes (T2D) and cognitive decline. Retinal microperimetry is a useful tool for detecting cognitive impairment in T2D. Morbid obesity (MO) has been associated with cognitive impairment. Insulin resistance (IR) seems a major determinant, but the data are unclear. The aim of this study was to evaluate the cognitive impairment in MO as well as the utility of retinal microperimetry in identifying these alterations. Methods: In total, 50 consecutive patients with MO were matched by age and gender with 30 healthy controls. All patients underwent cognitive evaluation (Montreal Cognitive Assessment Test-MoCA) and retinal microperimetry, using MAIA microperimeter 3rd generation. Retinal sensitivity and gaze fixation parameters were used for the evaluation of the analysis. Results: MO patients showed a significantly lower neurocognitive performance than the controls: MoCA score 24.94 2.74 vs. 28.95 1.05, p < 0.001. Cognitive function inversely correlated with the HOMA-IR (r = -0.402, p = 0.007). The AUROC for cognitive impairment using microperimetry was 0.807, CI 95% (0.592–0.947), p = 0.017. Conclusions: (1) Systemic insulin resistance is a major underlying mechanism accounting for the higher prevalence of cognitive impairment detected in young MO subjects. (2) Retinal microperimetry is a useful tool for identifying MO patients with cognitive impairment. Keywords: morbid obesity; cognitive impairment; retinal microperimetry; insulin resistance Author: Andreea Ciudin, Angel Ortiz, Enzamaria Fidilio, Diana Romero, Marta Sánchez, Marta Comas, Oscar Gonzalez, Ramon Vilallonga, Olga Simó-Servat, Cristina Hernández and Rafael Simó Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Wed Dec 11 10:58:28 2019 CET ModDate: Wed Dec 11 10:58:28 2019 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1405471 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XNEQPL+URWPalladioL-Ital Type 1 Custom yes yes no 48 0 JKBDGV+URWPalladioL-Bold Type 1 Custom yes yes no 49 0 QTLELQ+Pxbsy Type 1 Builtin yes yes no 50 0 ENXZUH+VnURWPalladioL-Bold Type 1 Custom yes yes no 51 0 ALUXHP+URWPalladioL-Roma Type 1 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