Beeri Michal Schnaider, Silverman Jeremy M, Davis Kenneth L, Marin Deborah, Grossman Hillel Z, Schmeidler James, Purohit Dushyant P, Perl Daniel P, Davidson Michael, Mohs Richard C, Haroutunian Vahram
Department of Psychiatry, Mount Sinai School of Medicine, New York, USA.
J Gerontol A Biol Sci Med Sci. 2005 Apr;60(4):471-5. doi: 10.1093/gerona/60.4.471.
In cross-sectional and longitudinal studies, type 2 diabetes has been positively associated with the risk of Alzheimer's disease (AD). The present descriptive study compared diabetic and nondiabetic subjects on the severity of neuritic plaques and neurofibrillary tangles (NFTs) in the cerebral cortex and in the hippocampus.
The study included specimens from 385 consecutive autopsies of residents of a nursing home (15.8% diabetics). Mean age at death = 84 years [standard deviation (SD) = 10], 66% were female, Clinical Dementia Rating mean = 3.0 (SD = 1.6), and 32.5% had an APOE4 allele. Additional analyses limited the sample to 268 subjects (14.1% diabetics) without neuropathology other than AD.
Analyses of covariance controlling for age at death, dementia severity (Clinical Dementia Rating score), and APOE4 allele indicated that diabetics had significantly fewer neuritic plaques (p =.008) and NFTs (p =.047) in the cerebral cortex than did nondiabetics. In the hippocampus, diabetics had significantly lower plaque ratings than did nondiabetics (p =.019), but the lower ratings of NFTs did not achieve statistical significance (p =.082). In the entire sample, diabetics had significantly less AD-associated neuropathology in all four analyses.
These results raise the possibility that the varied associations observed between diabetes and AD may be specific to as yet ill-defined subgroups of dementia and diabetic patients or may be more characteristic of younger patients than of those who survive to a mean age of 84 years. Future studies are encouraged to examine a variety of other characteristics such as age that may interact with diabetes affecting the incidence of AD.
在横断面研究和纵向研究中，2型糖尿病与阿尔茨海默病（AD）风险呈正相关。本描述性研究比较了糖尿病患者和非糖尿病患者大脑皮质及海马体中神经炎斑和神经原纤维缠结（NFTs）的严重程度。
该研究纳入了一家疗养院385例连续尸检的标本（15.8%为糖尿病患者）。平均死亡年龄 = 84岁[标准差（SD）= 10]，66%为女性，临床痴呆评定量表平均分 = 3.0（SD = 1.6），32.5%携带APOE4等位基因。进一步分析将样本限制为268例受试者（14.1%为糖尿病患者），这些受试者除AD外无其他神经病理学改变。
对死亡年龄、痴呆严重程度（临床痴呆评定量表评分）和APOE4等位基因进行协方差分析表明，与非糖尿病患者相比，糖尿病患者大脑皮质中的神经炎斑（p = 0.008）和NFTs（p = 0.047）明显更少。在海马体中，糖尿病患者的斑块评分显著低于非糖尿病患者（p = 0.019），但NFTs评分较低未达到统计学显著性（p = 0.082）。在整个样本中，在所有四项分析中糖尿病患者的AD相关神经病理学改变均明显较少。
这些结果提示，糖尿病与AD之间观察到的多种关联可能特定于尚未明确界定痴呆患者和糖尿病患者亚组，或者可能在年轻患者中比在平均年龄84岁的存活患者中更具特征性。鼓励未来研究考察各种其他可能与糖尿病相互作用影响AD发病率的特征，如年龄。
