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Neurology:胰岛素样生长因子或可预防痴呆及脑萎缩

2014-05-23 佚名 丁香园

糖尿病及其相关病因如胰岛素抵抗(IR)、肥胖、体力活动减少以及高热量摄入等均为痴呆的危险因素。在IR和糖尿病出现之前就发生了胰岛素样生长因子-1(IGF-1)水平的改变。IGF-1是一种由体力活动和低热量摄入诱发生成的激素。【原文下载】 该激素促进细胞生存,预防凋亡,并且调节海马神经再生。研究证实IGF-1在细胞培养和AD的转基因小鼠模型中均可抑制异常的tau蛋白磷酸化以及β淀粉样蛋白沉积。

糖尿病及其相关病因如胰岛素抵抗(IR)、肥胖、体力活动减少以及高热量摄入等均为痴呆的危险因素。在IR和糖尿病出现之前就发生了胰岛素样生长因子-1(IGF-1)水平的改变。IGF-1是一种由体力活动和低热量摄入诱发生成的激素。【原文下载】

该激素促进细胞生存,预防凋亡,并且调节海马神经再生。研究证实IGF-1在细胞培养和AD的转基因小鼠模型中均可抑制异常的tau蛋白磷酸化以及β淀粉样蛋白沉积。

在一项横断面研究中已发现较低的IGF-1水平与认知功能较差以及认知功能下降相关,但其与痴呆,尤其是阿尔茨海默病的相关性尚不明确。因此,来自美国的Sudha Seshadri教授等进行了一项研究,旨在无痴呆的社区中老年人群中明确IGF-1与阿尔茨海默病型痴呆风险以及脑容量之间的相关性。研究结果发表于最新一期《神经病学》杂志。



该研究纳入无痴呆的Framingham研究中受试者,总数为3,582例,平均年龄为65岁,57% 为女性。分别在1990-1994年以及1998-2001年间对受试者血清IGF-1进行检测,并进行前瞻性随访评估散发性痴呆和AD型痴呆的发生。在1999-2005年间对两代中无卒中也无痴呆的186例及1867例受试者行脑MRI检查。

采用Cox模型对基线IGF-1与痴呆发生风险进行相关性分析,采用多元线性回归分析脑总容积及海马体积与基线IGF-1相关性,并对年龄、性别、APOE e4、血清同型半胱氨酸、腰臀比以及体力活动等因素进行了校正。

研究结果发现,第一代受试者中平均IGF-1水平为144 ± 60 mg/L,第二代为114± 37 mg/L.为期7.4 ± 3.1年的随访期内,279例受试者发生散发性痴呆,其中230例为AD型痴呆。IGF-1水平最低的25%的受试者AD型痴呆发生风险增加51%.无痴呆的受试者中,较高的IGF-1水平与更大的脑容积相关。

研究者总结认为,较低的血清IGF-1水平与发生AD型痴呆风险增加相关;即使是在无痴呆也无卒中的中年健康社区受试者中,其也与更大的脑容量相关。较高的IGF-1水平或可保护亚临床和临床的神经退行性变。

该研究为大型的人群性研究,横跨2代人群,评估了影像学结果,具有严格的诊断学标准,这些加强了该研究的力度;然而该研究的局限在于仅纳入了欧洲人群,需要在其他种族背景的人群中进行独立的研究以验证该研究的结论。

原始出处:

Westwood AJ1, Beiser A, Decarli C, Harris TB, Chen TC, He XM, Roubenoff R, Pikula A, Au R, Braverman LE, Wolf PA, Vasan RS, Seshadri S.Insulin-like growth factor-1 and risk of Alzheimer dementia and brain atrophy.Neurology. 2014 May 6;82(18):1613-9. doi: 10.1212/WNL.0000000000000382. Epub 2014 Apr 4.【原文下载】



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    2017-05-28 ALY

    很好的研究

    0

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    2014-12-01 chendoc252
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    2014-10-14 yinhl1978
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    2014-09-07 baoya
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