Sadrolashrafi Kaviyon, Craft Suzanne, Decourt Boris, Adem Abdu, Wilson Jeffrey R, Miller Justin, Sabbagh Marwan N
Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas Nevada USA.
Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas Las Vegas Nevada USA.
Alzheimers Dement (Amst). 2021 Nov 10;13(1):e12248. doi: 10.1002/dad2.12248. eCollection 2021.
We examined the association between Alzheimer's disease (AD) and type 2 diabetes mellitus (DM) and hypothesized that diabetes is associated with an increased pathological burden in clinically and pathologically diagnosed AD.
All data were obtained from the Uniform Data Set (UDS) v3, the Neuropathology Data Set, and the Researcher's Data Dictionary-Genetic Data from the National Alzheimer's Coordinating Center. The dataset (37 cases with diabetes and 1158 cases without) relies on autopsy-confirmed data in clinically diagnosed AD patients who were assessed for diabetes type in form A5 or D2 during at least one visit. Differences in scores were explored using a general linear model. Effect sizes were calculated using sample means and standard deviations (Cohen's ).
The presence of diabetes was associated with a lower Thal phase of amyloid plaques (A score; 4.6 ± 0.79 vs. 4.3 ± 0.85, < .05) and lower Braak stage for neurofibrillary degeneration (B score; 5.58 ± 0.72 vs. 5.16 ± 0.96, < 0.05) but not for density of neocortical neuritic plaques (CERAD score-C score). The National Institute on Aging-Alzheimer's Association Alzheimer's disease neuropathologic change (ABC score) was not different between AD+DM and AD-DM.
This pilot study found a significantly lower Thal phase of amyloid plaques and Braak stage for neurofibrillary degeneration in AD-confirmed individuals with diabetes compared to those without. Thus type 2 DM is not associated with increased AD pathology in clinically and pathologically confirmed cases of AD.
我们研究了阿尔茨海默病（AD）与2型糖尿病（DM）之间的关联，并假设糖尿病与临床和病理诊断的AD中病理负担增加有关。
所有数据均来自统一数据集（UDS）v3、神经病理学数据集以及国家阿尔茨海默病协调中心的研究者数据字典 - 遗传数据。该数据集（37例糖尿病患者和1158例非糖尿病患者）依赖于临床诊断为AD的患者的尸检确诊数据，这些患者在至少一次就诊时通过A5或D2表格评估了糖尿病类型。使用一般线性模型探索分数差异。使用样本均值和标准差（科恩d值）计算效应大小。
糖尿病的存在与淀粉样斑块的较低Thal阶段（A评分；4.6±0.79对4.3±0.85，P<.05）和神经纤维变性的较低Braak阶段（B评分；5.58±0.72对5.16±0.96，P<0.05）相关，但与新皮质神经炎性斑块密度（CERAD评分 - C评分）无关。阿尔茨海默病神经病理改变的美国国立衰老研究所 - 阿尔茨海默病协会（ABC评分）在AD + DM组和AD - DM组之间没有差异。
这项初步研究发现，与无糖尿病的AD确诊个体相比，有糖尿病的个体淀粉样斑块的Thal阶段和神经纤维变性的Braak阶段显著更低。因此，在临床和病理确诊的AD病例中，2型DM与AD病理增加无关。
