Cardoso Susana, Seiça Raquel, Moreira Paula I
Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal.
CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.
Adv Neurobiol. 2017;19:117-150. doi: 10.1007/978-3-319-63260-5_5.
It is widely accepted that high calorie diets and a sedentary lifestyle sturdily influence the incidence and outcome of type 2 diabetes and obesity, which can occur simultaneously, a situation called diabesity. Tightly linked with metabolic and energy regulation, a close association between diabetes and Alzheimer's disease (AD) has been proposed. Among the common pathogenic mechanisms that underpin both conditions, insulin resistance, brain glucose hypometabolism, and metabolic dyshomeostasis appear to have a pivotal role. This century is an unprecedented diabetogenic period in human history, so therapeutic strategies and/or approaches to control and/or revert this evolving epidemic is of utmost importance. This chapter will make a brief contextualization about the impact that diabetes and obesity can exert in brain structure and function alongside with a brief survey about the role of insulin in normal brain function, exploring its roles in cognition and brain glucose metabolism. Later, attention will be given to the intricate relation of diabesity, insulin resistance, and AD. Finally, both pharmacological and lifestyle interventions will also be reviewed as strategies aimed at fighting diabesity and/or AD-related metabolic effects.
高热量饮食和久坐不动的生活方式会严重影响2型糖尿病和肥胖症的发病率及病情转归,这一点已得到广泛认可。2型糖尿病和肥胖症可能同时出现,这种情况被称为糖尿病型肥胖症。糖尿病与阿尔茨海默病(AD)之间存在紧密联系,二者均与代谢和能量调节密切相关。在这两种疾病共同的致病机制中,胰岛素抵抗、脑葡萄糖代谢减退和代谢失调似乎起着关键作用。本世纪是人类历史上前所未有的糖尿病高发期,因此控制和/或扭转这一不断发展的流行病的治疗策略和/或方法至关重要。本章将简要阐述糖尿病和肥胖症对脑结构和功能的影响,并简要概述胰岛素在正常脑功能中的作用,探讨其在认知和脑葡萄糖代谢中的作用。随后,将关注糖尿病型肥胖症、胰岛素抵抗与AD之间的复杂关系。最后,还将回顾药物和生活方式干预措施,作为对抗糖尿病型肥胖症和/或与AD相关的代谢影响的策略。