Meta-Analysis of Alzheimer's Disease Risk with Obesity, Diabetes, and Related Disorders
Meta-Analysis of Alzheimer's Disease Risk with Obesity, Diabetes, and Related Disorders
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DOI：
10.1016/j.biopsych.2009.02.013
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发表时间：
2010-03-15
影响因子：
10.6
通讯作者：
Faraone, Stephen V.
中科院分区：
文献类型：
--
作者：
Profenno, Louis A.;Porsteinsson, Anton P.;Faraone, Stephen V.
背景资料：迟发性阿尔茨海默病（AD）是一种多因素异质性疾病，其主要危险因素包括高龄、载脂蛋白E β 4（APOE 4）等位基因的存在和AD家族史。其他危险因素可能是肥胖和糖尿病及相关疾病，这是非常普遍的。方法：我们回顾了纵向流行病学研究的体重，糖尿病，代谢综合征，血糖和胰岛素水平的风险为AD。结果：对于以体重指数评估的肥胖，AD的合并效应量为1.59（95%置信区间[CI] 1.02-2.5; z = 2.0; p = 0.042），对于糖尿病，AD的合并效应量为1.54（95% Cl 1.33-1.79; z = 5.7; p < .001）。Egger的检验没有发现肥胖（t =-1.4，p = .21）或糖尿病（t =-0.86，p = .42）荟萃分析中存在发表偏见的显著证据。由于这些疾病是高度共病的，我们进行了一项荟萃分析，结合了所有关于肥胖、糖尿病和血糖或胰岛素水平异常的研究，得出了AD的高度显著的合并效应量为1.63（95%CI 1.39-1.92; z = 5.9; p < .001）。虽然风险水平低于APOE 4等位基因，但这些疾病的高患病率可能导致未来AD发病率的大幅增加。肥胖和糖尿病常见的生理变化必然会促进AD。
Background: Late-onset Alzheimer's disease (AD) is a multifactorial and heterogeneous disorder with major risk factors including advanced age, presence of an apolipoprotein E epsilon 4 (APOE4) allele, and family history of AD. Other risk factors may be obesity and diabetes and related disorders, which are highly prevalent.Methods: We reviewed longitudinal epidemiological studies of body mass, diabetes, metabolic syndrome, and glucose and insulin levels on risk for AD. We conducted meta-analyses of the results from these studies.Results: For obesity assessed by body mass index, the pooled effect size for AD was 1.59 (95% confidence interval [CI] 1.02-2.5; z = 2.0; p = .042), and for diabetes, the pooled effect size for AD was 1.54 (95% Cl 1.33-1.79; z = 5.7; p < .001). Egger's test did not find significant evidence for publication bias in the meta-analysis for obesity (t = -1.4, p = .21) or for diabetes (t = -.86,p = .42). Since these disorders are highly comorbid, we conducted a meta-analysis combining all studies of obesity, diabetes, and abnormal glucose or insulin levels, which yielded a highly significant pooled effect size for AD of 1.63 (95% Cl 1.39-1.92; z = 5.9; p < .001).Conclusions: Obesity and diabetes significantly and independently increase risk for AD. Though the level of risk is less than that with the APOE4 allele, the high prevalence of these disorders may result in substantial increases in future incidence of AD. Physiological changes common to obesity and diabetes plausibly promote AD.