Contribution of obesity, insulin resistance and diabetes mellitus to cognitive impairment

Abstract

Obesity is a vivid example of one of the most common chronic non-infectious multifactorial diseases in today’s world. Not only the conventional elements of an “unhealthy lifestyle” such as hypodynamia and overeating, but also external socio-economic and psychosocial factors play an important role in the development of this disease. This review summarizes the main pathogenetic components that combine the development of both metabolic and vascular, including cerebrovascular, complications of obesity. The authors present the current classification of obesity adopted by domestic endocrinologists, which includes an assessment of the risk of obesity-associated complications. The mechanisms of pathological effects of insulin resistance, which morphological substrate is visceral obesity, are considered in detail. Its key role in the initiation and progression of diabetes mellitus, cardiovascular and cerebrovascular diseases has been shown. The mechanisms involved in the development of cognitive impairment in patients with obesity, insulin resistance and diabetes mellitus are described. Due to the urgency of the problem raised, the prospective of choosing a therapeutic and preventive approach to the management of such patients are assessed. With regard to this category of patients, the use of fonturacetam was discussed. Fonturacetam has been shown to have the proven clinical effects that not only improve the cognitive and emotional status in patients with cerebrovascular pathology, but also have a direct effect on the potential root cause of the development and progression of vascular and metabolic disorders, i.e. on the obesity. Fonturacetam that has an anorexigenic effect can also be prescribed as a weight corrector in addition to the diet therapy. Thus, the use of fonturacetam can become a promising trend in the treatment and prevention of today’s most common diseases.