Madetko-Alster Natalia, Otto-Ślusarczyk Dagmara, Struga Marta, Kutyłowski Michał, Drzewińska Agnieszka, Duszyńska-Wąs Karolina, Migda Bartosz, Alster Piotr
Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland.
Department of Biochemistry, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland.
J Clin Med. 2024 Jan 14;13(2):465. doi: 10.3390/jcm13020465.
Multiple studies have analyzed the possible correlations between diabetes and Alzheimer's disease. Less is known about the context of cognitive deterioration among patients with atypical Parkinsonian syndromes and glucose metabolism impairment. The aim of this study was to evaluate the association between the impaired glucose metabolism and cognitive decline among patients with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). The study included 22 patients with PSP and CBS with disease durations varying from 3 to 6 years. The levels of glycated hemoglobin (HbA1C), fasting blood glucose, fasting C-peptide and the presence of microalbuminuria were evaluated, and oral glucose tolerance tests (OGTT) were performed. Based on the OGTT results, the glycemic variability, mean glycemia, glycemia standard deviation (SD) and coefficient of variation (%CV) were calculated. All patients underwent a three-Tesla brain magnetic resonance (MRI) examination and neuropsychological cognitive assessment with the use of standardized scales: Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). A statistical analysis revealed that poor control of glycemia with high glycemic variability and increased atrophy of the medial temporal lobe among patients with PSP and CBS correlated with worse cognitive performance independent of age or sex, even among patients who did not fulfill the criteria for diabetes. The study results indicate the importance of glucose metabolism control and optimal treatment in the context of cognition maintenance among patients with PSP and CBS. Due to the relatively small number of analyzed patients, the issue requires further assessment. To the best of our knowledge, this is the first study discussing the role of glycemic variability in atypical Parkinsonian syndromes.
多项研究分析了糖尿病与阿尔茨海默病之间可能存在的关联。对于非典型帕金森综合征患者认知功能恶化与糖代谢受损之间的关系，我们了解得较少。本研究的目的是评估进行性核上性麻痹（PSP）和皮质基底节综合征（CBS）患者糖代谢受损与认知功能下降之间的关联。该研究纳入了22例PSP和CBS患者，病程从3年到6年不等。评估了糖化血红蛋白（HbA1C）、空腹血糖、空腹C肽水平以及微量白蛋白尿的情况，并进行了口服葡萄糖耐量试验（OGTT）。根据OGTT结果，计算血糖变异性、平均血糖、血糖标准差（SD）和变异系数（%CV）。所有患者均接受了3特斯拉脑磁共振成像（MRI）检查，并使用标准化量表进行神经心理学认知评估：蒙特利尔认知评估量表（MoCA）、简易精神状态检查表（MMSE）和额叶评估量表（FAB）。统计分析显示，PSP和CBS患者血糖控制不佳、血糖变异性高以及内侧颞叶萎缩增加与较差的认知表现相关，且不受年龄或性别的影响，即使在未达到糖尿病诊断标准的患者中也是如此。研究结果表明，在PSP和CBS患者认知功能维持方面，控制糖代谢和进行最佳治疗具有重要意义。由于分析的患者数量相对较少，该问题需要进一步评估。据我们所知，这是第一项探讨血糖变异性在非典型帕金森综合征中作用的研究。
