散发性阿尔茨海默病患者胰岛素抵抗与血脂皮质醇的临床研究

A clinical study of insulin resistence serum lipid and cortisol in patients with sporadic Alzheimer's disease

目的探讨散发性阿尔茨海默病(SAD)患者胰岛素抵抗、血清胰岛素、胆固醇、甘油三酯与皮质醇的变化。方法对34例SAD患者和32例正常对照组血清胰岛素、空腹血糖、胆固醇(TC)、甘油三酯(TG)与皮质醇进行测定,计算胰岛素敏感指数,并进行组间对比研究。其中SAD组根据痴呆临床评定量表(CDR)得分进一步分轻度、中度、重度痴呆组进行比较。结果血清胰岛素、皮质醇浓度和胰岛素敏感指数各组间相比无显著性差异(P>0.05)。轻度痴呆患者TC、TG显著高于中度和重度痴呆组(P<0.05),中度痴呆组TG和重度痴呆组TC显著低于正常对照组(P<0.05)。结论部分散发性AD患者的外周胰岛素抵抗可能无显著性改变,随痴呆程度的加重,血清胆固醇、甘油三酯有降低趋势,提示中重度SAD痴呆患者特别需要加强营养支持。

Objective To investigate the change of peripheral insulin resistance, serum insulin, cholesterol, triglyceride and cortisol in sporadic Alzheimer＇s disease （SAD） . Methods To measure serum concentration of insulin, cholesterol, triglyceride cortisol and fasting serum glucose in 34 patients with SAD and 32 normal controls respectively, calculate insulin sensitive index （ISI） . After grouping by degree of dementia with Clinical Dementia Rating Scale, the results were compared between each two groups. Results The levels of serum insulin, cortisol and ISI had no significant difference among each groups （P 〉 0. 05 ） . Serum total cholesterol and triglyceride levels in mild AD patients were significant higher than those in moderate and severe AD patients （ P 〈 0. 05 ）, triglyceride in moderate AD and cholesterol in severe AD patients were significant lower than those in normal elder （ P 〈 0.05 ） . Conclusion Peripheral insulin resistence in some patients with SAD perhaps had no significant change, the level of serum cholesterol and triglyeeride decreased with worsening of degree, These results suggest that we should pay more attention to nutrition support on moderate and severe AD patients.