胰岛素抵抗综合征特征与阿尔茨海默病之间的关联：独立于载脂蛋白E4表型的基于人群的横断面研究。

Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study.

作者信息

Kuusisto J, Koivisto K, Mykkänen L, Helkala E L, Vanhanen M, Hänninen T, Kervinen K, Kesäniemi Y A, Riekkinen P J, Laakso M

机构信息

Department of Medicine, Kuopio University Hospital, Finland.

出版信息

BMJ. 1997 Oct 25;315(7115):1045-9. doi: 10.1136/bmj.315.7115.1045.

DOI:10.1136/bmj.315.7115.1045

PMID:9366728

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2127678/

Abstract

OBJECTIVE

To determine the association between features of the insulin resistance syndrome and Alzheimer's disease.

DESIGN

Cross sectional population based study.

SUBJECTS

980 people aged 69 to 78 (349 men, 631 women).

SETTING

Population of Kuopio, eastern Finland.

MAIN OUTCOME MEASURES

Presence of features of the insulin resistance syndrome and diagnosis of Alzheimer's disease by detailed neurological and neuropsychological evaluation.

RESULTS

46 (4.7%) subjects were classified as having probable or possible Alzheimer's disease. In univariate analyses, apolipoprotein E4 phenotype (odds ratio; 95% confidence interval 3.24: 1.77 to 5.92), age (1.16; 1.05 to 1.29), low level of education (0.82; 0.72 to 0.93), low total cholesterol concentration (0.77; 0.59 to 1.00), high systolic blood pressure (1.01; 1.00 to 1.03), high fasting and 2 hour plasma glucose concentrations (1.11; 1.01 to 1.23 and 1.08; 1.03 to 1.13, respectively), high fasting and 2 hour insulin concentrations (1.05; 1.02 to 1.08 and 1.003; 1.00 to 1.01, respectively), and abnormal glucose tolerance (1.86; 1.23 to 2.80) were significantly associated with Alzheimer's disease. In multivariate analysis including apolipoprotein E4 phenotype, age, education, systolic blood pressure, total cholesterol concentration, fasting glucose concentration, and insulin concentration, apolipoprotein E4 phenotype, age, education, total cholesterol, and insulin were significantly associated with Alzheimer's disease. In 532 non-diabetic subjects without the e4 allele hyperinsulinaemia was associated with an increased risk for Alzheimer's disease (prevalence of disease 7.5% v 1.4% in normoinsulinaemic subjects, P = 0.0004). In contrast, in the 228 with the e4 allele hyperinsulinaemia had no effect on the risk of disease (7.0% v 7.1%, respectively).

CONCLUSION

Features of the insulin resistance syndrome are associated with Alzheimer's disease independently of apolipoprotein E4 phenotype.

摘要

目的

确定胰岛素抵抗综合征特征与阿尔茨海默病之间的关联。

设计

基于人群的横断面研究。

研究对象

980名年龄在69至78岁之间的人（男性349名，女性631名）。

研究地点

芬兰东部库奥皮奥的人群。

主要观察指标

胰岛素抵抗综合征特征的存在情况以及通过详细的神经学和神经心理学评估诊断阿尔茨海默病。

结果

46名（4.7%）受试者被归类为可能患有或疑似患有阿尔茨海默病。在单因素分析中，载脂蛋白E4表型（比值比；95%置信区间3.24：1.77至5.92）、年龄（1.16；1.05至1.29）、低教育水平（0.82；0.72至0.93）、低总胆固醇浓度（0.77；0.59至1.00）、高收缩压（1.01；1.00至1.03）、高空腹和餐后2小时血浆葡萄糖浓度（分别为1.11；1.01至1.23和1.08；1.03至1.13）、高空腹和餐后2小时胰岛素浓度（分别为1.05；1.02至1.08和1.003；1.00至1.01）以及糖耐量异常（1.86；1.23至2.80）与阿尔茨海默病显著相关。在包括载脂蛋白E4表型、年龄、教育程度、收缩压、总胆固醇浓度、空腹血糖浓度和胰岛素浓度的多因素分析中，载脂蛋白E4表型、年龄、教育程度、总胆固醇和胰岛素与阿尔茨海默病显著相关。在532名无e4等位基因的非糖尿病受试者中，高胰岛素血症与阿尔茨海默病风险增加相关（疾病患病率在高胰岛素血症受试者中为7 .5%，在正常胰岛素血症受试者中为1.4%，P = 0.0004）。相比之下，在228名有e4等位基因的受试者中，高胰岛素血症对疾病风险无影响（分别为7.0%和7.1%）。