Research Progress on the Impact of Metabolic Syndrome on Cognitive Impairment

近年来，代谢综合征(MetS)与认知障碍的关联机制及干预策略日益受到重视。本文系统综述了MetS影响认知功能的研究进展，重点从以下病理生理机制展开阐述：(1) 中枢神经系统功能异常(涵盖海马体损伤、中枢胰岛素抵抗、氧化应激及瘦素抵抗)；(2) 外周信号介导机制(涉及高甘油三酯血症、慢性低度炎症、下丘脑–垂体–肾上腺轴失调)；(3) 血管性因素(以脑血流灌注不足为核心)。在干预领域，归纳了生活方式干预(饮食调控、运动疗法)、药物治疗(降糖/调脂/降压/神经保护剂)、心理干预等多模式临床路径。文末总结指出，当前研究仍需深化机制探索(尤其肠–脑轴与表观遗传调控)、优化循证干预方案，并加强跨学科协作，以制定精准化防治策略，应对MetS相关认知衰退的公共卫生挑战。In recent years, the pathogenic mechanisms linking metabolic syndrome (MetS) to cognitive impairment and corresponding intervention strategies have garnered increasing attention. This systematic review summarizes research advances on the impact of MetS on cognitive function, focusing on the following pathophysiological mechanisms: (1) Central nervous system dysfunction (encompassing hippocampal damage, central insulin resistance, oxidative stress, and leptin resistance); (2) Peripheral signaling-mediated mechanisms (involving hypertriglyceridemia, chronic low-grade inflammation, and hypothalamic-pituitary-adrenal axis dysregulation); and (3) Vascular factors (centered on cerebral hypoperfusion). In the intervention domain, the review outlines multimodal clinical pathways including lifestyle interventions (dietary regulation, exercise therapy), pharmacotherapy (hypoglycemic, lipid-lowering, antihypertensive, and neuroprotective agents), and psychological interventions. The article concludes by noting that current research still needs to deepen mechanistic exploration (especially the gut-brain axis and epigenetic regulation), optimize evidence-based intervention protocols, and strengthen interdisciplinary collaboration to formulate precise prevention and treatment strategies addressing the public health challenge of MetS-associated cognitive decline.