阿尔茨海默病与血糖、胰岛素及胰岛素抵抗的相关性研究  

Research on Correlation between Late-onset Alzheimer's Disease and Blood Glucose,Insulin and Insulin Resistance.

作　　者：李金庚 

机构地区：[1]浙江省永康市红十字会医院神经内科,321300

出　　处：《心脑血管病防治》2013年第4期275-278,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨晚发性阿尔茨海默病(late-onset Alzheimer’s disease,LOAD)与血糖、胰岛素及胰岛素抵抗的关系,为早期诊断及治疗LOAD提供理论依据。方法选择55例LOAD患者为观察组,按照GDS分为轻、中、重度组分别与3O例同龄正常老年人(对照组)进行比较。采用葡萄糖氧化酶法和化学发光法分别检测其血糖和胰岛素水平并计算胰岛素抵抗指数。胰岛素抵抗指数采用HOMA2-IR公式。结果与对照组比较,观察组空腹胰岛素均上升,胰岛素抵抗均高于对照组。观察组LOAD空腹胰岛素(97.18±10.31)pmol/L,轻度组(106.67±10.51)pmol/L,中度组(92.03±5.36)pmol/L,重度组(93.24±7.48)pmol/L与对照组(67.93±14.75)pmol/L比较差异有统计学意义(P<0.05)。HOMA2-IR:LOAD观察组(3.21±0.12),轻度组(3.31±0.02),中度组(3.13±0.12),重度组(3.21±0.11)与对照组(2.83±0.24)比较有统计学意义(P<0.05),空腹血糖及餐后血糖各组间比较无统计学意义。结论 LOAD患者体内对胰岛素及胰岛素抵抗的调节可能出现障碍,对65岁以上人群常规检查空腹胰岛素及胰岛素抵抗指数,有利于早期诊断及治疗LOAD。Objective To explore relations between late-onset Alzheimer＇s disease （LOAD） and blood glucose, insulin and insulin resistance and thus to provide theoretical evidence for early diagnosis and treatment of LOAD. Methods 55 cases of lOAD patients （experimental group） were selected, and they were divided into slight, moderate and severe cases in accordance with GDS and com- paring them with 30 cases of the normal elderly who at the same age （control group）. Then we determined its blood glucose and insulin levels with the method of glucose oxidase and chemoluminescence respectively and calculated insulin resistance index in the form of HOMA2-IR. Results Compared with control group, fasting insulin levels all rised and insulin resistance indexes were higher in the experimental group. For fasting insulin, LOAD in overall group was 97.18 ± 10.31pmol/L, LOAD in slight group （ 106.67 ± 10.51） pmol/L , LOAD in moderate group （92.03 ± 5.36）pmol/L and LOAD in severe group （93.24 ± 7.48）pmol/L. Compared with （67.93 ± 14.75） pmol/L in control group, statistic difference existed, i.e., P 〈 0.05. HOMA2-IR： LOAD in overall group is （3.21 ±0.12）, LOAD in slight group is （3.31 ± 0.02）, LOAD in moderate group is （3.13±0.12） and LOAD in severe group is （3.21 ± 0.11）. Compared with control group （2.83 ±0.24）, statistic difference existed, i.e., P 〈 0.05. There was no statistically difference between groups for fasting blood glucose and postprandial blood glucose. Conclusions Before LOAD patients suffering pathoglycemia, fasting insulin rises and insulin resistance occurs. Regulation to insulin and insulin resistance may not be performed well for LOAD patients. Examining fasting insulin and insulin resistance index routinely is good for diagnosis and treatment of LOAD at the early stage for the elderly above 65 years old.

关 键 词：晚发性阿尔茨海默病 胰岛素 胰岛素抵抗 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R446.112[医药卫生—临床医学]