Type 2 diabetes is negatively associated with Alzheimer's disease neuropathology
Type 2 diabetes is negatively associated with Alzheimer's disease neuropathology
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DOI：
10.1093/gerona/60.4.471
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发表时间：
2005-04-01
影响因子：
5.1
通讯作者：
Haroutunian, V
中科院分区：
文献类型：
--
作者：
Beeri, MS;Silverman, JM;Haroutunian, V
背景。在横断面和纵向研究中，2型糖尿病与阿尔茨海默病（AD）的风险呈正相关。本描述性研究比较了糖尿病和非糖尿病受试者在大脑皮层和海马体中神经斑块和神经原纤维缠结（nft）的严重程度。该研究包括385例养老院居民连续尸检标本（15.8%为糖尿病患者）。平均死亡年龄为84岁[标准差(SD) = 10]， 66%为女性，临床痴呆评分平均值为3.0 (SD = 1.6)， 32.5%携带APOE4等位基因。额外的分析将样本限制在268名受试者（14.1%为糖尿病患者），除ad外无神经病理。控制死亡年龄、痴呆严重程度（临床痴呆评分）和APOE4等位基因的协方差分析表明，糖尿病患者的大脑皮层神经斑块（p = 0.008）和nft （p = 0.047）明显少于非糖尿病患者。在海马区，糖尿病患者斑块评分明显低于非糖尿病患者（p = 0.019），但nft评分较低无统计学意义（p = 0.082）。在整个样本中，糖尿病患者在所有四种分析中都明显减少了ad相关的神经病理。这些结果提出了一种可能性，即糖尿病和AD之间观察到的各种关联可能是针对尚未明确的痴呆和糖尿病患者亚组的，或者可能更具有年轻患者的特征，而不是那些平均活到84岁的患者。鼓励未来的研究检查各种其他特征，如年龄，可能与糖尿病相互作用，影响AD的发病率。
Background. In cross-sectional and longitudinal studies, type 2 diabetes has been positively associated with the risk of Alzheimer's disease (AD). The present descriptive study compared diabetic and nondiabetic Subjects on the severity of neuritic plaques and neurofibrillary tangles (NFTs) in the cerebral cortex and in the hippocampus.Methods. The study included specimens from 385 consecutive autopsies of residents of a nursing home (15.8% diabetics). Mean age at death = 84 years [standard deviation (SD) = 10], 66% were female, Clinical Dementia Rating mean = 3.0 (SD = 1.6), and 32.5% had an APOE4 allele. Additional analyses limited the sample to 268 subjects (14.1% diabetics) without neuropathology other than AD.Results. Analyses of covariance controlling for age at death, dementia severity (Clinical Dementia Rating score), and APOE4 allele indicated that diabetics had significantly fewer neuritic plaques (p = .008) and NFTs (p = .047) in the cerebral cortex than did nondiabetics. In the hippocampus, diabetics had significantly lower plaque ratings than did nondiabetics (p = .019), but the lower ratings of NFTs did not achieve statistical significance (p = .082). In the entire sample, diabetics had significantly less AD-associated neuropathology in all four analyses.Conclusions. These results raise the possibility that the varied associations observed between diabetes and AD may be specific to as yet ill-defined subgroups of dementia and diabetic patients or may be more characteristic Of Younger patients than of those who survive to a mean age of 84 years. Future studies are encouraged to examine a variety of other characteristics such as age that may interact with diabetes affecting the incidence of AD.