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Insulin resistance and risk of dementia and cognitive impairment in older Mexican Americans.

機譯：墨西哥裔美國人的胰島素抵抗以及癡呆和認知障礙的風險。

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摘要

Type 2 diabetes is implicated as a risk factor for cognitive impairment in older ages, but the mechanisms for this association are uncertain. The role of diabetes, hyperinsulinemia, body fat distribution, and a polymorphism in the peroxisome proliferator-activated receptor-gamma gene, Pro 12Ala, in relation to incidence of cognitive impairment were examined in a cohort of 1,789 Mexican Americans. Participants were aged 60-101 at baseline in 1998-99 and residents of the Sacramento, California area. Dementia and 'cognitive impairment but not demented' (CIND) status were determined annually by a multi-stage assessment protocol. Incident cases of dementia and CIND were combined. Analyses were conducted using Cox proportional hazards regression. The hazard ratio (HR) relating diabetes to dementia/CIND after 4 years of follow-up was 2.7 (1.6, 4.8). In non-diabetic participants age 60-80 years at baseline, an increase of 10 muIU/mL of insulin was associated with an HR of 1.8 (1.2, 2.7) for dementia/CIND. A weak inverse relationship was observed between insulin and rate of dementia/CIND among non-diabetic participants older than age 80 at baseline (HR = 0.56; 0.16, 2.0). There was an increased rate of dementia/CIND among diabetic individuals for carriers of the Ala variant of the Pro12Ala polymorphism after 5 years of follow-up (HR = 2.1; 1.0, 4.4) and an increased rate for male carriers of an Ala allele (HR = 2.5; 1.2, 5.2) but not for females (HR = 0.74; 0.37, 1.5). Compared to those with body mass index 25.0 kg/m2, participants with a body mass index of 25.0-29.9 kg/m2 had a 48% decrease in rate of dementia/CIND (HR = 0.52; 0.30 to 0.91), while participants with body mass index ≥30 kg/m2 had a 61% decreased rate of dementia/CIND (HR = 0.39; 0.20, 0.78). There was a moderate positive association between waist circumference and dementia/CIND for the middle tertile of waist circumference compared to the lowest textile (HR = 1.8; 1.1, 3.1) and for those in the highest tertile compared to the lowest (HR = 1.9; 0.91, 3.8). The improvement of insulin sensitivity in older ages may have beneficial effects on cognitive health.
機譯：2型糖尿病是老年人認知障礙的危險因素，但這種關聯的機制尚不確定。在1789名墨西哥裔美國人隊列中，研究了糖尿病，高胰島素血癥，體內脂肪分布以及過氧化物酶體增殖物激活的受體-γ基因Pro 12Ala多態(tài)性與認知障礙發(fā)生率的關系。參與者在1998-99年的基線年齡為60-101歲，是加利福尼亞州薩克拉門托的居民。癡呆癥和“認知障礙但未癡呆”狀態(tài)（CIND）每年通過多階段評估方案確定。合并癡呆和CIND的事件病例。使用Cox比例風險回歸進行分析。隨訪4年，糖尿病與癡呆/ CIND相關的危險比（HR）為2.7（1.6，4.8）。在基線時年齡為60-80歲的非糖尿病參與者中，癡呆/ CIND的胰島素升高10μIU/ mL與HR分別為1.8（1.2、2.7）有關。在基線時，年齡在80歲以上的非糖尿病參與者中，胰島素與癡呆/ CIND的比率之間存在弱的反比關系（HR = 0.56; 0.16，2.0）。隨訪5年后，糖尿病個體中Pro12Ala多態(tài)性Ala變異攜帶者的癡呆/ CIND發(fā)生率增加（HR = 2.1； 1.0、4.4），而Ala等位基因男性攜帶者發(fā)生率增加（ HR = 2.5; 1.2，5.2），但女性不適用（HR = 0.74; 0.37，1.5）。與體重指數<25.0 kg / m2的受試者相比，體重指數為25.0-29.9 kg / m2的受試者癡呆/ CIND發(fā)生率降低了48％（HR = 0.52； 0.30至0.91），而體重指數≥30kg / m2時癡呆/ CIND降低率61％（HR = 0.39; 0.20，0.78）。與最低的紡織品（HR = 1.8； 1.1、3.1）相比，在腰圍的中部三分位數與腰圍與老年癡呆癥/ CIND之間存在中等程度的正相關性；在最低三分位數的紡織品中，最低腰圍（HR = 1.9； HR = 1.9; 0.91，3.8）。老年人胰島素敏感性的改善可能對認知健康產生有益的影響。

著錄項

  • 作者

    West, Nancy A.;

  • 作者單位

    University of Michigan.;

  • 授予單位 University of Michigan.;
  • 學科 Gerontology.;Hispanic American Studies.;Health Sciences Public Health.;Psychology Cognitive.
  • 學位 Ph.D.
  • 年度 2006
  • 頁碼 83 p.
  • 總頁數 83
  • 原文格式 PDF
  • 正文語種 eng
  • 中圖分類 老年病學;預防醫(yī)學、衛(wèi)生學;心理學;
  • 關鍵詞

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