The relationship between cognitive performance and insulin resistance in non-diabetic patients with mild cognitive impairment
The relationship between cognitive performance and insulin resistance in non-diabetic patients with mild cognitive impairment
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DOI：
10.1002/gps.4181
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发表时间：
2015-06-01
影响因子：
4
通讯作者：
Park, Sun Ah
中科院分区：
文献类型：
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作者：
Kim, Tae-Eun;Lee, Dong Hyun;Park, Sun Ah
目的：胰岛素抵抗（IR）是2型糖尿病和代谢综合征的一个独特且早期的特征。IR被认为在认知障碍中起着至关重要的作用。我们进行这项研究是为了了解由IR导致的认知功能障碍的早期特征。
方法：本研究纳入了85名连续的患有轻度认知障碍（MCI）的非糖尿病老年参与者。用胰岛素抵抗的稳态模型评估（HOMA - IR）来评估IR。根据HOMA - IR评分分析认知表现。
结果：有IR和无IR组的分析在认知表现上未显示出任何差异，尽管较高的HOMA - IR与首尔语言学习测试（SVLT - I）的即时回忆（r = -0.244，p = 0.026）和控制口头词语联想测试（COWAT）（r = -0.270，p = 0.013）中的较差表现密切相关。在按载脂蛋白E（APOE）状态进行的亚组分析中，在有APOE ε4等位基因的参与者中，IR组的SVLT - 延迟回忆（p = 0.027）和COWAT（p = 0.016）得分显著低于非IR组。在多元回归分析中，COWAT的受损仍然与HOMA - IR评分显著相关（β = -0.271，t = -2.340，p = 0.022）。然而，发现IR状态与APOE ε4携带状态相互作用，导致COWAT表现不佳（β = -0.335，t = -2.285，p = 0.026）。
结论：本研究发现HOMA - IR评分对非糖尿病的MCI患者的认知表现有特定领域的影响。这种关联仅在APOE ε4携带者中显著。版权所有（C）2014约翰威立父子有限公司
Objective: Insulin resistance (IR) is a distinct and early feature of type 2 diabetes mellitus and metabolic syndrome. IR is thought to play a vital role in cognitive impairment. We conducted this study to understand the early characteristics of cognitive dysfunctions attributable to IR.Methods: This study included 85 consecutive non-diabetic elderly participants with mild cognitive impairment (MCI). IR was estimated with the homeostasis model assessment of insulin resistance (HOMA-IR). Cognitive performances were analyzed as a function of scores on the HOMA-IR.Results: The group analysis those with and without IR did not show any differences in the cognitive performance although higher HOMA-IR was closely associated with lower performances in immediate recall on the Seoul Verbal Learning Test (SVLT-I) (r=-0.244, p =0.026) and Controlled Oral Word Association Test (COWAT) (r =-0.270, p =0.013). In subgroup analysis by APOE status, SVLT-delayed (p=0.027) and COWAT (p =0.016) scores were found to be significantly lower in the IR than the non-IR among those with APOE epsilon 4 allele. In multiple regression analysis, impairment on the COWAT remained significantly correlated with scores on HOMA-IR (beta =-0.271, t =-2.340, p =0.022). However, IR status was identified to interact with APOE epsilon 4 carriership toward poor performances in the COWAT (beta =-0.335, t =-2.285, p=0.026).Conclusion: This study found a domain-specific impact of HOMA-IR scores on cognitive performances in non-diabetic patients with MCI. This association was profound only in APOE epsilon 4 carriers. Copyright (C) 2014 John Wiley & Sons, Ltd.