Novo Nordisk Inc., NJ, USA.
MCPHS University, Boston, MA, USA.
Obes Rev. 2018 Feb;19(2):269-280. doi: 10.1111/obr.12629. Epub 2017 Oct 10.
Alzheimer's disease (AD) is the sixth leading cause of death in the USA today; therefore, it is imperative that public health initiatives and clinical strategies are developed to prevent and effectively treat AD. Despite the enormous impact that AD has on individuals, families, society, and the health care system, there are no biomarkers to clearly identify those at risk for AD, public health prevention strategies in place, or treatments to address the underlying pathology or stop the progression of AD. There is ample scientific as well as empirical evidence that obesity and its metabolic and vascular comorbidities are related to AD and likely in the causative pathway. Obesity prevention and treatment could prove to be an efficacious and safe approach to preventing AD, a serious and daunting epidemic disease. In this review, we present the current pathophysiological and clinical evidence linking obesity and obesity-related comorbidities (eg, insulin resistance, hyperglycaemia, and type 2 diabetes) with AD. Additionally, we discuss which population to target and when to consider treatment for AD. Finally, we summarize the current evidence regarding the efficacy of anti-obesity and anti-diabetic pharmacotherapeutic agents for the treatment of AD.
阿尔茨海默病（AD）是当今美国第六大死亡原因；因此，必须制定公共卫生措施和临床策略来预防和有效治疗 AD。尽管 AD 对个人、家庭、社会和医疗保健系统造成了巨大影响，但目前尚无生物标志物可明确识别 AD 风险人群、制定公共卫生预防策略、或治疗方法来解决潜在的病理问题或阻止 AD 的进展。有充分的科学和经验证据表明，肥胖及其代谢和血管合并症与 AD 有关，并且可能处于致病途径中。肥胖的预防和治疗可能被证明是预防 AD 的一种有效且安全的方法，AD 是一种严重且令人生畏的流行疾病。在这篇综述中，我们提出了目前将肥胖症及其相关合并症（例如胰岛素抵抗、高血糖和 2 型糖尿病）与 AD 联系起来的病理生理学和临床证据。此外，我们讨论了应针对哪些人群以及何时考虑 AD 的治疗。最后，我们总结了目前关于抗肥胖和抗糖尿病药物治疗 AD 的疗效的证据。
