胰岛素对阿尔茨海默病患者血浆β-淀粉样蛋白的差异调节

作     者：Kulstad J.J Green P.S Cook D.G S. Craft 郭俊 

作者机构：VAPSHCS S-182-GRECC 1660 S. Columbian Way Seattle WA 98108 United States Dr. 

出 版 物：《世界核心医学期刊文摘(神经病学分册)》 (Digest of the World Core Medical Journals.Clinical Neurology)

年 卷 期：2006年第11期

页      面：57-58页

学科分类：1002[医学-临床医学] 100205[医学-精神病与精神卫生学] 10[医学] 

主　　题：胰岛素 AD 多肽 β-淀粉样蛋白 阿尔茨海默病 患者 血浆 

摘      要：BACKGROUND: Hyperinsulinemia and insulin resistance are risk factors for memory impairment and Alzheimer disease (AD). Insulin regulates levels of the amyloid β-peptide (Aβ)in vitro in neuronal cultures and in vivo in the CSF of normal older adults. OBJECTIVE: To determine whether insulin affected plasma Aβlevels and whether such effects differed for patients with AD compared with normal older adults. METHODS: Fifty-nine patients with AD and 50 healthy older adults each received infusions of saline and of insulin (1.0 mU·kg·min)with accompanying dextrose to maintain euglycemia. A subset of participants (19 AD, 12 normal) received two additional conditions, in which insulin was infused at a lower (0.33 mU·kg·min) and higher (1.67 mU·kg·min) rate. Plasma insulin and Aβ.were measured after 120 minutes of infusion. RESULTS: Adults with AD had higher plasma insulin vs normal adults at the two higher infusion rates, despite receiving comparable amounts of insulin. For normal adults, insulin reduced plasma Aβlevels at the middle (1.0 mU·kg·min) dose, with attenuated effects at lower and higher doses. In contrast, for patients with AD, insulin raised plasma Aβ.levels at the two higher doses (1.0 and 1.67 mU·kg·min). CONCLUSIONS: These results suggest that patients with Alzheimer disease (AD) have reduced insulin clearance and insulin-provoked plasma amyloid β-peptide (Aβ) elevation. Abnormal regulation of peripheral Aβby insulin may contribute to AD risk.