NEURODEGENERATION IN DIABETES MELLITUS
NEURODEGENERATION IN DIABETES MELLITUS
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DOI：
10.1007/978-1-4614-0653-2_19
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发表时间：
2012-01-01
影响因子：
3
通讯作者：
Umegaki, Hiroyuki
中科院分区：
文献类型：
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作者：
Umegaki, Hiroyuki
糖尿病被认为是一组异质性疾病，具有由于胰岛素缺乏、胰岛素作用的有效性受损或两者所致的高血糖和葡萄糖耐受不良的共同要素。2型糖尿病（T2DM）的患病率随着年龄的增长而增加，痴呆也会增加其在晚年的发病率。最近的研究表明，T2DM是认知功能障碍或痴呆的危险因素，特别是与阿尔茨海默病（AD）相关的那些。胰岛素抵抗通常与T2DM相关，可能导致中枢神经系统（CNS）中胰岛素效应不足。胰岛素可能具有神经保护作用，并可能对乙酰胆碱（ACh）合成产生一定影响。2型糖尿病患者胰岛素抵抗引起的高胰岛素血症可能与胰岛素通过血脑屏障（BBB）转运减少引起的胰岛素缺乏有关。胰岛素在大脑中具有多种重要功能。然而，一些基础研究，表明胰岛素通过影响β淀粉样蛋白（A β）加速阿尔茨海默病相关的病理学2型糖尿病患者无症状的缺血性病变可能降低痴呆发生的阈值，这可能是基础研究与临床病理研究不一致的原因，需要更多的研究来阐明2型糖尿病相关神经退行性变的机制。
Diabetes mellitus is recognized as a group of heterogeneous disorders with the common elements of hyperglycaemia and glucose intolerance due to insulin deficiency, impaired effectiveness of insulin action, or both. The prevalence of Type 2 diabetes mellitus (T2DM) increases with age and dementia also increases its incidence in later life. Recent studies have revealed that T2DM is a risk factor for cognitive dysfunction or dementia, especially those related to Alzheimer's disease (AD). Insulin resistance, which is often associated with T2DM, may induce a deficiency of insulin effects in the central nervous system (CNS). Insulin may have a neuroprotective role and may have some impact on acetylcholine (ACh) synthesis. Ilyperinsulinemia, induced by insulin resistance occurring in T2DM, may be associated with insulin deficiency caused by reduced insulin transport via the blood brain barrier (BBB). Insulin has multiple important functions in the brain. Some basic research, however, suggests that insulin accelerates Alzheimer-related pathology through its effects on the amyloid beta (A beta) metabolism and tau phosphorylation.Asymptomatic ischemic lesions in T2DM subjects may lower the threshold for the development of dementia and this may explain the inconsistency between the basic research and clinicopathological studies.More research to elucidate the mechanism of neurodegeneration associated with T2DM is warranted.