Shinohara Mitsuru, Tashiro Yoshitaka, Suzuki Kaoru, Fukumori Akio, Bu Guojun, Sato Naoyuki
Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan.
Department of Aging Neurobiology Graduate School of Medicine Osaka University Suita Osaka Japan.
Alzheimers Dement (Amst). 2020 Feb 6;12(1):e12006. doi: 10.1002/dad2.12006. eCollection 2020.
Although diabetes and apolipoprotein E (apoE) are both significant risk factors for dementia, including Alzheimer's disease, it remains to be clarified how they are related to each other in contributing to the risk of dementia.
By reviewing the National Alzheimer's Coordinating Center (NACC) clinical records, we investigated whether diabetes affects cognitive decline depending on genotype and their potential relationships with neuropathology.
A significant interaction between diabetes and genotype exists, where diabetes affected cognitive decline in carriers and carriers, but not carriers. Moreover, the presence of vascular pathology was increased by diabetes in carriers, while carriers nearly reached plateau levels irrespective of diabetes.
Diabetes accelerates cognitive decline, in part, through accelerating vascular impairment in non- ε4 carriers, but such effects are negligible in carriers, who themselves are already vulnerable to vascular impairment.
尽管糖尿病和载脂蛋白E（apoE）都是包括阿尔茨海默病在内的痴呆症的重要风险因素，但它们在导致痴呆症风险方面如何相互关联仍有待阐明。
通过回顾国家阿尔茨海默病协调中心（NACC）的临床记录，我们研究了糖尿病是否根据基因型影响认知衰退以及它们与神经病理学的潜在关系。
糖尿病与基因型之间存在显著相互作用，糖尿病影响ε4携带者和ε2携带者的认知衰退，但不影响ε3携带者。此外，糖尿病使ε4携带者的血管病理学发生率增加，而ε2携带者无论是否患糖尿病几乎都达到了平稳水平。
糖尿病部分通过加速非ε4携带者的血管损伤来加速认知衰退，但在本身就易患血管损伤的ε4携带者中，这种影响可忽略不计。
