阿尔茨海默病与胰岛素及胰岛素抵抗的相关性研究

Study on the Relationship between Alzheimer's Disease and Insulin and Insulin Resistance

目的探讨阿尔茨海默病(AD)与胰岛素及胰岛素抵抗的关系,为临床提供参考。方法方便选取2015年3月—2018年3月该院收治的94例AD患者为研究组,另同期择选94名健康者为对照组,观察比较两组血脂、血糖、空腹胰岛素、2 h胰岛素以及胰岛素抵抗指数变化,分析各指标与阿尔茨海默病患者认知功能的相关性。结果研究组患者与对照组健康者的总胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、餐后2 h胰岛素(2 h INS)水平变化比较,差异无统计学意义(P>0.05);研究组患者空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA2-IR)水平分别为(97.59±7.44)p IU/L、(3.22±0.53),高于对照组的(63.82±5.86)p IU/L、(2.72±0.54),均差异有统计学意义(t=30.881、5.170,P<0.05);痴呆筛查量表(MMSE)评分明显低于对照组,差异有统计学意义(P<0.05);FINS与HOMA2-IR指数水平与MMSE评分呈明显负相关性(r=-0.408、-0.132,P<0.05)。结论 AD患者的胰岛素及胰岛素抵抗水平明显升高且与AD患者的认知功能呈负相关性,能够作为早期诊断指标在临床应用。

Objective To investigate the relationship between Alzheimer＇s disease（AD） and insulin and insulin resistance,and provide reference for clinical practice. Methods A total of 94 AD patients admitted to the hospital from March 2015 to March 2018 were convenient selected as the study group. In the same period, 94 healthy subjects were selected as the control group. The blood lipids, blood glucose, fasting insulin, 2 h insulin, and insulin resistance index changes were observed and compared between the two groups, analysis of the correlation between each index and cognitive function in patients with Alzheimer＇s disease. Results Total cholesterol（CHO）, triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, lowdensity lipoprotein cholesterol（LDL-C）, fasting blood glucose（FBG） in study group and control healthy group had no significant difference in the levels of 2 h postprandial blood glucose（2 h PBG） and postprandial 2 h insulin（2 h INS） levels（P〉0.05）; fasting insulin（FINS） and insulin resistance index（HOMA2-IR） levels in the study group were（97.59 ±7.44）pIU/L,（3.22±0.53）, higher than that of the control group（63.82±5.86） pIU/L,（2.72±0.54）, and the difference was statistically significant（t=30.881, 5.170, P〈0.05）; Dementia screening scale（MMSE） score was significantly lower than the control group, the difference was statistically significant（P〈0.05）; FINS and HOMA2-IR index levels were significantly negatively correlated with the MMSE score（r=-0.408,-0.132, P〈0.05）. Conclusion The levels of insulin and insulin resistance in patients with AD are significantly elevated and negatively correlated with the cognitive function of AD patients. It can be used as an early diagnostic indicator in clinical applications.