Li Zhi, Li Simian, Xiao Ying, Zhong Tian, Yu Xi, Wang Ling
Faculty of Medicine, Macau University of Science and Technology, Macau, China.
Front Nutr. 2022 Nov 15;9:1046726. doi: 10.3389/fnut.2022.1046726. eCollection 2022.
The combined disease burden of diabetes mellitus (DM) and Alzheimer's disease (AD) is increasing, and the two diseases share some common pathological changes. However, the pharmacotherapeutic approach to this clinical complexity is limited to symptomatic rather than disease-arresting, with the possible exception of metformin. Whether nutritional intervention might extend or synergize with these effects of metformin is of interest. In particular, dietary patterns with an emphasis on dietary diversity shown to affect cognitive function are of growing interest in a range of food cultural settings. This paper presents the association between diabetes and AD. In addition, the cross-cultural nutritional intervention programs with the potential to mitigate both insulin resistance (IR) and hyperglycemia, together with cognitive impairment are also reviewed. Both dietary patterns and nutritional supplementation showed the effects of improving glycemic control and reducing cognitive decline in diabetes associated with AD, but the intervention specificity remained controversial. Multi-nutrient supplements combined with diverse diets may have preventive and therapeutic potential for DM combined with AD, at least as related to the B vitamin group and folate-dependent homocysteine (Hcy). The nutritional intervention has promise in the prevention and management of DM and AD comorbidities, and more clinical studies would be of nutritional scientific merit.
糖尿病(DM)和阿尔茨海默病(AD)的合并疾病负担正在增加,且这两种疾病存在一些共同的病理变化。然而,针对这种临床复杂性的药物治疗方法仅限于对症治疗而非疾病阻止,二甲双胍可能是个例外。营养干预是否能扩展二甲双胍的这些作用或与之协同增效,这是一个值得关注的问题。特别是,强调饮食多样性且已证明会影响认知功能的饮食模式,在一系列饮食文化背景中受到越来越多的关注。本文阐述了糖尿病与阿尔茨海默病之间的关联。此外,还综述了有可能减轻胰岛素抵抗(IR)、高血糖以及认知障碍的跨文化营养干预项目。饮食模式和营养补充剂均显示出改善血糖控制以及减少与阿尔茨海默病相关的糖尿病患者认知衰退的作用,但干预的特异性仍存在争议。多种营养素补充剂与多样化饮食相结合,可能对糖尿病合并阿尔茨海默病具有预防和治疗潜力,至少与B族维生素组和叶酸依赖性同型半胱氨酸(Hcy)相关。营养干预在糖尿病和阿尔茨海默病合并症的预防和管理方面具有前景,更多的临床研究将具有营养科学价值。