Hyperinsulinemia and risk of Alzheimer disease
Hyperinsulinemia and risk of Alzheimer disease
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DOI：
10.1212/01.wnl.0000140292.04932.87
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发表时间：
2004-10-12
期刊：
影响因子：
9.9
通讯作者：
Mayeux, R
中科院分区：
文献类型：
--
作者：
Luchsinger, JA;Tang, MX;Mayeux, R
目的：探讨空腹胰岛素水平与痴呆的关系。方法：从曼哈顿北部65岁及以上人群中随机抽取一组老年受试者，用固相化学发光酶免疫法测定冰冻血清中的空腹胰岛素水平。痴呆症是用标准方法诊断的。所有受试者在每个随访间隔都可以进行神经精神测试。结果：共对683名非痴呆患者进行了3691人年的跟踪调查，149人发生痴呆，其中阿尔茨海默病137人，卒中痴呆6人，其他6人。患有高胰岛素血症的39%的样本中，AD的风险增加了一倍(HR=2.1；95%CI：1.5，2.9)，并且在没有糖尿病的人中风险最高。在我们的样本中，高胰岛素血症或糖尿病的存在与AD相关的HR为2.2(95%CI：1.5，3.1)。高胰岛素血症或糖尿病导致AD的风险为39%。胰岛素水平最高的四分位数与最低四分位数的AD的HR分别为1.70(95%CI：1.0，2.7；趋势P=0.009)。高胰岛素血症也与记忆相关认知分数的显著下降有关，但与其他认知领域的下降无关。结论：高胰岛素血症与AD和记忆力下降的风险较高有关。
Objective: To explore the association between fasting insulin levels and dementia. Methods: Fasting insulin levels were measured from frozen sera using solid-phase chemiluminescent enzyme immunoassay in a sample of elderly subjects chosen at random from a cohort of persons aged 65 years and older from northern Manhattan. Dementia was diagnosed using standard methods. Neuropsychiatric testing was available on all subjects at each follow-up interval. Results: A total of 683 subjects without prevalent dementia were followed for 3,691 person-years and 149 persons developed dementia ( 137 Alzheimer disease [ AD], 6 dementia associated with stroke, 6 other). The risk of AD doubled in the 39% of the sample with hyperinsulinemia (HR = 2.1; 95% CI: 1.5, 2.9) and was highest in people without diabetes. The HR relating presence of hyperinsulinemia or diabetes in 50% of our sample to AD was 2.2 ( 95% CI: 1.5, 3.1). The risk of AD attributable to the presence of hyperinsulinemia or diabetes was 39%. The HR of AD for the highest quartile of insulin compared to the lowest was 1.7 ( 95% CI: 1.0, 2.7; p for trend = 0.009). Hyperinsulinemia was also related to a significant decline in memory-related cognitive scores, but not to decline in other cognitive domains. Conclusions: Hyperinsulinemia is associated with a higher risk of AD and decline in memory.