Cao Huimin, Zhao Yuying, Chen Ziyi, Zou Xiaoya, Du Xinyi, Yi Li, Ai Yu, Zuo Hongzhou, Cheng Oumei
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, The Second People's Hospital of Banan District, Chongqing, China.
NPJ Parkinsons Dis. 2025 Aug 13;11(1):240. doi: 10.1038/s41531-025-01100-1.
Heterogeneity is an important feature of cognitive impairment in patients with Parkinson's disease (PD), with emerging evidence linking insulin resistance to accelerated cognitive decline. Our investigation examined the relationship between the triglyceride-glucose (TyG) index-a marker of insulin resistance-and cognition and striatal dopamine transporter (DAT) alterations in PD through cross-sectional and longitudinal analyses. In the primary cohort, higher TyG correlated with lower Mini-Mental State Examination (MMSE) scores (p < 0.001) and increased dementia risk (p = 0.014). Longitudinal analysis in the PPMI cohort showed higher baseline TyG predicted greater Montreal Cognitive Assessment (MoCA) decline (p = 0.019) and reduced DAT activity in caudate (p = 0.033) and putamen (p = 0.019) over 4 years.DAT activity in the caudate mediated 24.1% of the TyG index's longitudinal effect on MoCA scores, while the TyG index mediated 16.9% of CSF GLP-1R's effect. These results highlight the TyG index as a potential biomarker for identifying PD patients at higher risk of cognitive impairment.
异质性是帕金森病（PD）患者认知障碍的一个重要特征，越来越多的证据表明胰岛素抵抗与认知功能加速衰退有关。我们的研究通过横断面和纵向分析，探讨了甘油三酯-葡萄糖（TyG）指数（一种胰岛素抵抗标志物）与PD患者认知及纹状体多巴胺转运体（DAT）改变之间的关系。在主要队列中，较高的TyG与较低的简易精神状态检查表（MMSE）评分相关（p < 0.001），且痴呆风险增加（p = 0.014）。PPMI队列的纵向分析显示，较高的基线TyG预示着4年内蒙特利尔认知评估（MoCA）下降幅度更大（p = 0.019），尾状核（p = 0.033）和壳核（p = 0.019）的DAT活性降低。尾状核中的DAT活性介导了TyG指数对MoCA评分纵向效应的24.1%，而TyG指数介导了脑脊液GLP-1R效应的16.9%。这些结果突出了TyG指数作为识别认知障碍风险较高的PD患者的潜在生物标志物的作用。
