{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:28:37Z","timestamp":1790702917281,"version":"4.1.0"},"reference-count":53,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82030026"],"award-info":[{"award-number":["82030026"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82270883"],"award-info":[{"award-number":["82270883"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82000775"],"award-info":[{"award-number":["82000775"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key Research and Development Program of Jiangsu Province of China","award":["BE2022666"],"award-info":[{"award-number":["BE2022666"]}]},{"name":"Natural Science Foundation of Jiangsu Province of China","award":["BK20200114"],"award-info":[{"award-number":["BK20200114"]}]},{"name":"Six Talent Peaks Project of Jiangsu Province of China","award":["YY-086"],"award-info":[{"award-number":["YY-086"]}]},{"name":"Affiliated Drum Tower Hospital"},{"name":"Medical School of Nanjing University","award":["2022-LCYJ-ZD-03"],"award-info":[{"award-number":["2022-LCYJ-ZD-03"]}]},{"name":"Medical School of Nanjing University","award":["2022-LCYJ-PY-02"],"award-info":[{"award-number":["2022-LCYJ-PY-02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Although cognitive impairment in nonalcoholic fatty liver disease (NAFLD) has received attention in recent years, little is known about detailed cognitive functions in histologically diagnosed individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to investigate the association of liver pathological changes with cognitive features and further explore the underlying brain manifestations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and Patients<\/jats:title>\n                  <jats:p>We performed a cross-sectional study in 320 subjects who underwent liver biopsy. Among the enrolled participants, 225 underwent assessments of global cognition and cognitive subdomains. Furthermore, 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 structural equation model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with controls, patients with NAFLD had poorer immediate memory and delayed memory. Severe liver steatosis (odds ratio, 2.189; 95% CI, 1.020-4.699) and ballooning (OR, 3.655; 95% CI, 1.419-9.414) were related to a higher proportion of memory impairment. Structural magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis exhibited volume loss in left hippocampus and its subregions of subiculum and presubiculum. Task-based magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis had decreased left hippocampal activation. Path analysis demonstrated that higher NAFLD activity scores were associated with lower subiculum volume and reduced hippocampal activation, and such hippocampal damage contributed to lower delayed memory scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We are the first to report the presence and severity of NAFLD to be associated with an increased risk of memory impairment and hippocampal structural and functional abnormalities. These findings stress the significance of early cognitive evaluation in patients with NAFLD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad352","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T13:21:20Z","timestamp":1686403280000},"page":"3239-3249","source":"Crossref","is-referenced-by-count":36,"title":["The Presence and Severity of NAFLD are Associated With Cognitive Impairment and Hippocampal Damage"],"prefix":"10.1210","volume":"108","author":[{"given":"Yingwen","family":"Miao","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , Nanjing 210008 , China"},{"name":"Branch of National Clinical Research Centre for Metabolic Diseases , Nanjing 210008 , 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