Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Alzheimer's Disease Research Center, Karolinska Institutet, Stockholm, Sweden.
J Alzheimers Dis. 2010;22(2):405-13. doi: 10.3233/JAD-2010-100795.
Previous studies have failed to reach consensus on insulin levels in cerebrospinal fluid of Alzheimer's disease (AD) patients and on its relation to pathological features. We performed a new analysis in patients at different stages of AD, and investigated the relationship of insulin levels with biochemical disease markers and with cognitive score. We included 99 patients from our Memory Clinic (Karolinska University Hospital, Sweden), including: 27 patients with mild AD, 13 that progressed from mild cognitive impairment (MCI) to AD in two years time, 26 with MCI stable after two years, and 33 with subjective cognitive impairment. Insulin was significantly decreased in the cerebrospinal fluid of both women and men with mild AD. Insulin deficits were seen in women belonging to both MCI groups, suggesting that this occurs earlier than in men. Insulin was positively associated with amyloid-β 1-42 (Aβ1-42) levels and cognitive score. Furthermore, total-tau/(Aβ1-42*insulin) ratio showed strikingly better sensitivity and specificity than the total-tau/Aβ1-42 ratio for early AD diagnosis in women.
先前的研究未能就阿尔茨海默病（AD）患者脑脊液中的胰岛素水平及其与病理特征的关系达成共识。我们在 AD 不同阶段的患者中进行了新的分析，并研究了胰岛素水平与生化疾病标志物和认知评分的关系。我们纳入了来自我们记忆诊所（瑞典卡罗林斯卡大学医院）的 99 名患者，包括：27 名轻度 AD 患者，13 名在两年内从轻度认知障碍（MCI）进展为 AD 的患者，26 名两年后 MCI 稳定的患者，以及 33 名主观认知障碍患者。在女性和男性轻度 AD 患者的脑脊液中，胰岛素明显降低。在属于两个 MCI 组的女性中也观察到胰岛素不足，这表明这一现象比男性更早发生。胰岛素与淀粉样蛋白-β 1-42（Aβ1-42）水平和认知评分呈正相关。此外，与总 tau/Aβ1-42 比值相比，总 tau/(Aβ1-42*胰岛素)比值在女性 AD 早期诊断中具有更高的敏感性和特异性。
