Stanford Center for Neuroscience in Women's Health, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stan-ford, CA 94305-5723, USA.
Neurobiol Aging. 2011 Nov;32(11):1942-8. doi: 10.1016/j.neurobiolaging.2009.12.005. Epub 2009 Dec 23.
Insulin resistance (IR) is the main pathological condition underlying vascular disorders, such as diabetes and cardiovascular disease, which are well established risk factors for cognitive decline and Alzheimer disease (AD). Hippocampal atrophy has been associated with cognitive decline, but little is known about the influence of IR on hippocampus integrity in non-diabetic, cognitively intact individuals. Herein, 50 women ages 50-65, current users of hormone therapy, underwent magnetic resonance imaging, cognitive testing, and homeostatic assessment of insulin resistance (HOMA-IR), as part of a longitudinal study examining brain structure and function in postmenopausal women at risk for AD. Results demonstrated a significant negative relationship between HOMA-IR and right and total hippocampal volume, overall cognitive performance, and selective tests of verbal and non-verbal memory. The main effect of HOMA-IR on brain structure and cognition was not altered by the presence of APOE-ε4 allele or by reproductive history, such as duration of endogenous and exogenous estrogen exposure. These results suggest that IR in middle-aged individuals at risk for AD may be biomarker for dementia risk.
胰岛素抵抗（IR）是血管紊乱的主要病理状况，如糖尿病和心血管疾病，这些都是认知能力下降和阿尔茨海默病（AD）的既定风险因素。海马体萎缩与认知能力下降有关，但对于非糖尿病、认知功能正常的个体中胰岛素抵抗对海马体完整性的影响知之甚少。在此，50 名年龄在 50-65 岁之间、正在使用激素治疗的女性作为一项纵向研究的一部分，接受了磁共振成像、认知测试和胰岛素抵抗的稳态评估（HOMA-IR），该研究旨在检查有患 AD 风险的绝经后女性的大脑结构和功能。结果表明，HOMA-IR 与右侧和总海马体体积、整体认知表现以及言语和非言语记忆的选择性测试呈显著负相关。APOE-ε4 等位基因的存在或生殖史（如内源性和外源性雌激素暴露的持续时间）并没有改变 HOMA-IR 对大脑结构和认知的主要影响。这些结果表明，AD 风险中年个体的 IR 可能是痴呆风险的生物标志物。
