Neurology and Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran.
Student Research Committee, Qom University of Medical Sciences, Qom, Iran.
Acta Neurol Belg. 2020 Aug;120(4):901-906. doi: 10.1007/s13760-019-01084-9. Epub 2019 Feb 1.
Central insulin resistance is involved in the pathophysiology of Alzheimer's disease (AD). Visfatin (VIS), an adipokine secreted from peripheral adipose tissue, is involved in energy balance and weight control. Besides its metabolic roles, VIS possesses insulin-mimetic, anti-apoptotic, and neuroprotective properties. In this study, we assessed the presence of a correlation between plasma VIS level and insulin resistance or AD. Sixty participants were enrolled in this study; 34 patients with AD and 26 healthy subjects. All subjects underwent comprehensive evaluations including Mini-mental score exam (MMSE) for the diagnosis of dementia. Subjects with MMSE score < 24 were added to the AD group, while healthy subjects should have a MMSE score > 27. Fasting blood sugar (FBS) and insulin levels were measured by enzyme-linked immunosorbent assay. The results indicate a significant elevation in FBS from 103 ± 3.0 to 147 ± 7.6 in AD patients (p ≤ 0.001). Additionally, 71% of AD patients developed insulin resistance, as the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index increased from 2.9 ± 0.5 in healthy subjects to 5.2 ± 0.7 in AD patients (p ≤ 0.05). Body mass index and serum insulin level did not show a significant alteration, but serum VIS levels were significantly (p ≤ 0.01) lower in AD patients (11.15 ± 1.9 ng/ml) in comparison to control group (21.09 ± 2.3 ng/ml). There is a negative correlation between plasma VIS level and the HOMA-IR index (p < 0.05). The results of this study present clear evidence for systemic insulin resistance and decreased serum VIS level in non-obese, non-overweight patients with moderate to severe AD.
中枢胰岛素抵抗参与阿尔茨海默病（AD）的病理生理学。内脏脂肪素（VIS）是一种由外周脂肪组织分泌的脂肪因子，参与能量平衡和体重控制。除了其代谢作用外，VIS 还具有胰岛素模拟、抗凋亡和神经保护作用。在这项研究中，我们评估了血浆 VIS 水平与胰岛素抵抗或 AD 之间是否存在相关性。这项研究共纳入 60 名参与者，其中 34 名 AD 患者和 26 名健康受试者。所有受试者均接受了全面评估，包括用于诊断痴呆的简易精神状态检查（MMSE）。MMSE 评分<24 的受试者被纳入 AD 组，而健康受试者的 MMSE 评分应>27。通过酶联免疫吸附试验测量空腹血糖（FBS）和胰岛素水平。结果表明，AD 患者的 FBS 从 103±3.0 显著升高至 147±7.6（p≤0.001）。此外，71%的 AD 患者出现胰岛素抵抗，因为稳态模型评估的胰岛素抵抗指数（HOMA-IR）从健康受试者的 2.9±0.5 增加至 AD 患者的 5.2±0.7（p≤0.05）。体重指数和血清胰岛素水平没有明显变化，但 AD 患者的血清 VIS 水平显著降低（p≤0.01），与对照组相比（11.15±1.9ng/ml），AD 患者为 11.15±1.9ng/ml（21.09±2.3ng/ml）。血浆 VIS 水平与 HOMA-IR 指数呈负相关（p<0.05）。本研究结果为非肥胖、非超重的中重度 AD 患者存在全身胰岛素抵抗和血清 VIS 水平降低提供了明确证据。
