Yaffe Kristine
Department of Psychiatry, University of California, San Francisco VA Medical Center, San Francisco, CA 94121, USA.
Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):167-71. doi: 10.1097/WAD.0b013e318065bfd6.
Given the anticipated exponential increase in both the incidence and prevalence of dementia, it is critical to identify preventative strategies and improved treatments for this disorder. The metabolic syndrome is comprised of 5 cardiovascular risk factors that include abdominal obesity, hypertriglyceridemia, low high-density lipoprotein levels, hypertension, and hyperglycemia. The prevalence of the metabolic syndrome, similar to that for cognitive disorders, increases dramatically with age. Several possible mechanisms may explain an association between the metabolic syndrome and cognitive decline including microvascular and macrovascular disease, inflammation, adiposity, and insulin resistance. Although some of the individual components of the metabolic syndrome have been linked to risk of developing dementia and cognitive impairment, few studies have looked at the components of the metabolic syndrome as a whole. We found, in 3 separate studies involving elders of different ethnicities, that the metabolic syndrome is a risk factor for accelerated cognitive aging. This was especially true for elders with the metabolic syndrome and with elevated serum level of inflammation. If metabolic syndrome is associated with increased risk of developing cognitive impairment, regardless of mechanism, then early identification and treatment of these individuals might offer avenues for disease course modification.
鉴于预计痴呆症的发病率和患病率将呈指数级增长，确定针对这种疾病的预防策略和改进治疗方法至关重要。代谢综合征由5种心血管危险因素组成，包括腹部肥胖、高甘油三酯血症、低高密度脂蛋白水平、高血压和高血糖。代谢综合征的患病率与认知障碍的患病率一样，会随着年龄的增长而急剧上升。几种可能的机制可以解释代谢综合征与认知衰退之间的关联，包括微血管和大血管疾病、炎症、肥胖和胰岛素抵抗。虽然代谢综合征的一些个别组成部分已与患痴呆症和认知障碍的风险相关联，但很少有研究将代谢综合征的各个组成部分作为一个整体来研究。我们在3项针对不同种族老年人的独立研究中发现，代谢综合征是加速认知衰老的一个危险因素。对于患有代谢综合征且血清炎症水平升高的老年人来说尤其如此。如果代谢综合征与发生认知障碍的风险增加相关，无论其机制如何，那么对这些个体的早期识别和治疗可能为改变疾病进程提供途径。
