糖尿病致阿尔茨海默病的运动干预作用及机制

Effect and Mechanism of Exercise Intervention in Alzheimer’s Disease Induced by Diabetes

流行病学研究表明,糖尿病患者罹患阿尔茨海默病(Alzheimer’s disease,AD)的机率明显增加,说明糖尿病可能在AD发病中扮演关键角色。此外,糖尿病所致脑胰岛素信号异常、神经炎症、氧化应激及线粒体功能障碍、血管功能障碍等致病因素,可通过多种途径导致β-淀粉样蛋白积累和Tau磷酸化,加速神经细胞死亡,进而加重认知功能障碍,促使AD发生。近年来研究发现,多种抗糖尿病药物对AD均有不同程度的改善疗效或作用。运动亦可通过缓解神经炎症状态、抑制氧化应激及线粒体功能障碍、改善内皮功能及脑血管功能障碍、诱导神经发生等多种关键内在机制,改善糖尿病致AD相关病理改变。为此,该综述将对糖尿病致AD的病理机制和部分抗糖尿病药物对其防治机制进行总结,并探讨运动改善糖尿病致AD的干预作用及机制,以期为其治疗的多样性提供更多理论参考依据。

Epidemiological studies have shown that the incidence of AD (Alzheimer’s disease) in patients with diabetes is significantly increased,suggesting that diabetes may play a key role in the development of AD.In addition,diabetic encephalic insulin signal abnormalities,neuroinflammation,oxidative stress,mitochondrial dysfu-nction,vascular dysfunction and other pathogenic factors can lead to amyloid-β accumulation and Tau phosphorylation through a variety of ways,accelerate nerve cell death,and further aggravate cognitive dysfunction and promote the occurrence of AD.In recent years,it has been found that a variety of anti-diabetes drugs can improve the efficacy or effect of AD to varying degrees.Exercise can also improve the pathological changes related to AD caused by diabetes by alleviating neuroinflammatory state,inhibiting oxidative stress and mitochondrial dysfunction,improving endothelial function and cerebrovascular dysfunction,and inducing neurogenesis.Therefore,this review will summarize the pathological mechanism of diabetes-induced AD and the prevention and treatment mechanism of some antidiabetic drugs,and explore the intervention effect and mechanism of exercise in improving diabetes-induced AD,in order to provide more theoretical reference for the diversity of its treatment.