Enhancement of memory in Alzheimer disease with insulin and somatostatin, but not glucose
Enhancement of memory in Alzheimer disease with insulin and somatostatin, but not glucose
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DOI：
10.1001/archpsyc.56.12.1135
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发表时间：
1999-12-01
影响因子：
--
通讯作者：
Veith, RC
中科院分区：
文献类型：
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作者：
Craft, S;Asthana, S;Veith, RC
背景：提高血糖水平可改善阿尔茨海默病(AD)患者的记忆力。增加血糖水平还会增加内源性胰岛素水平，这就提出了一个问题，即记忆的改善是否源于胰岛素的变化，而不是高血糖。方法：23例AD患者和14例年龄相近的健康成人分别在4种代谢状态下接受4种代谢状态：(1)高胰岛素血症(538pmo1/L)合并空腹血糖(5.6mmo1/L[100 mg/dL])，由胰岛素和可变葡萄糖输注实现；(2)高血糖(12.5 mmol/L[225 mg/dL])合并空腹胰岛素(57pmoL/L)，由葡萄糖和生长抑素(奥曲肽)输注(150 mg/h)；(3)安慰剂+等渗盐水(空腹胰岛素和葡萄糖)输注；(4)单用生长抑素(150 mg/h)。结果：阿尔茨海默病患者在高胰岛素状态下记忆力较安慰剂改善(P=0.05)，较高血糖状态下改善(P<0.05)。
Background: Increasing plasma glucose levels improves memory in patients with Alzheimer disease (AD). Increasing plasma glucose levels also increases endogenous insulin levels, raising the question of whether memory improvement is due to changes in insulin, independent of hyperglycemia. We address this question by examining memory and counterregulatory hormone response during hyperglycemia when endogenous insulin was suppressed by concomitant infusion of the somatostatin analogue octreotide (Sandostatin).Methods: Twenty-three patients with AD and 14 similarly aged healthy adults participated in 4 metabolic conditions on separate days: (1) hyperinsulinemia (538 pmol/L) with fasting glucose (5.6 mmol/L [100 mg/dL]), achieved by insulin and variable dextrose infusion; (2) hyperglycemia (12.5 mmol/L [225 mg/dL]) with fasting insulin (57 pmol/L), achieved by dextrose and somatostatin (octreotide) infusion (150 mg/h); (3) placebo with isotonic sodium chloride solution (saline) infusion (fasting insulin and glucose); and (4) an active control condition in which somatostatin alone was infused (150 mg/h). Declarative memory (story recall) and selective attention (Stroop interference test) were measured during steady metabolic states.Results: Patients with AD showed improved memory during hyperinsulinemia relative to placebo (P = .05) and relative to hyperglycemia (P