阿尔茨海默病精神行为症状与代谢综合征及胰岛素抵抗关系的研究

Study on behavioural and psychological symptoms of Alzheimer's disease and insulin resistance,metabolic syndrome

目的探讨阿尔茨海默病患者精神行为症状与胰岛素抵抗、代谢综合征的关系。方法研究对象包括86例阿尔茨海默病患者,均无痴呆家族史,根据中华医学会糖尿病分会关于"代谢综合征"的诊断标准(2004)划分为无或有代谢综合征两组进行对照,检测血脂、血压、空腹血糖、胰岛素等,采用基础状态法评定胰岛素抵抗性,计算胰岛素敏感指数。应用神经精神症状问卷(NPI)评定精神行为症状,并用SPSS16.0软件包进行统计分析。结果两组最少见的精神行为症状均为情感高涨或欣快,有代谢综合征组最常见的症状为易激惹(92.3%),对照组为异常运动行为(78.5%)。有代谢综合征患者组激越和易激惹症状显著多于无代谢综合征组(P<0.15),多元回归分析显示与NPI得分显著相关的有年龄、收缩压和低密度脂蛋白(P<0.15)。两组间空腹胰岛素、胰岛素敏感指数无统计学差异。结论代谢综合征对阿尔茨海默病患者精神行为症状表现有影响,特别是高龄、高血压和低密度脂蛋白增高。暂未发现胰岛素抵抗与NPI评分的精神行为症状相关。

Objective To examine the association among behavioural and psychological symptoms of Alzheimer＇s disease and insulin resistance,metabolic syndrome（MS）.Methods This study included 86 patients with Alzheimer＇s disease who were divided as two groups according to the diagnostic criteria of metabolic syndrome by Chinese Medical Association Diabetes Branch.That was Non-MS（NMS）group and MS group.All subjects did not have family history of dementia and had fasting levels of glucose,insulin,lipid and blood pressure measured.Insulin resistance was estimated with the Insulin Sensitive Index（ISI）.Behavioural and psychological symptoms of AD was assessed by Neuropsychiatric Inventory（NPI）.Results The very seldom symptom of both group was elation/euphoria.The most common symptom of MS group was irritability（92.3%）and that of NMS group was aberrant motor behavior（78.5%）.There were obviously more symptoms of agitation and irritability in MS group than that in NMS group（P0.15）.Age,systolic blood pressure and low density lipoprotein were associated with NPI score（P0.15）.Fasting insulin and ISI had not obviously difference between two groups.Conclusions Our finding suggest MS influence behavioural and psychological symptoms of Alzheimer＇s disease.What＇s more,the finding suggest insulin resistance is not associated with NPI score.