阿尔茨海默病与代谢相关因子水平的研究

发布时间：2018-06-01 13:27

本文选题：阿尔茨海默病 + 胰岛素　；参考：《山东大学》2012年硕士论文

【摘要】：背景阿尔茨海默病(Alzheimer's disease,AD)是发生于老年期和老年前期,以进行性认知功能下降和行为损害为特征的中枢神经系统退行性病变,是老年期痴呆的最常见类型。自1907年德国神经病理学家阿尔茨海默首次报告以来,该疾病的特征越来越被人们所认识。近年来随着我国人口老龄化的加重,阿尔茨海默病的发病率及患病率也逐渐增高。但阿尔茨海默病的发病机制尚不完全明确,代谢障碍可能是引起阿尔茨海默病的病因之一。糖代谢异常导致AD的潜在机制可能与高血糖的直接毒性,低血糖导致大脑能量供应不足,胰岛素抵抗及胰岛素信号转导异常,胰岛素降解酶(insulin-degrading enzyme,IDE)基因异常等有关。脂源性因子瘦素(leptin,LP)是1994年发现的由脂肪组织分泌的激素,与糖代谢障碍、肥胖等密切相关。近年来发现瘦素对阿尔茨海默病的发生起保护作用,瘦素水平下降可能参与阿尔茨海默病的发病过程,。因此,研究代谢相关因子胰岛素、胰岛素降解酶及瘦素与AD的关系,有助于了解AD的发病机制,为治疗和预防阿尔茨海默病提供新的思路和方法。第一部分阿尔茨海默病患者血糖、胰岛素及胰岛素降解酶水平的研究目的：探讨阿尔茨海默病与血糖、胰岛素及胰岛素降解酶的关系,为进一步防治阿尔茨海默病提供理论依据。方法：选择32例阿尔茨海默病患者(实验组)和30例正常老年人(对照组),进行简明精神状态量表(MMSE)及临床痴呆评定量表(CDR)评分,按照CDR得分再将实验组分为轻、中、重度组。同时测量两组的身高、体重、空腹血糖、血脂等,采用酶联免疫吸附法和化学发光法分别检测其血清胰岛素降解酶(IDE)和胰岛素水平并计算胰岛素抵抗指数及体质量指数,对上述因子进行统计学分析,寻找各因子之间的相互关系。结果： 1、独立样本t检验结果显示实验组与对照组在身高、体重、BMI、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、胰岛素及胰岛素抵抗指数方面无显著差异(P0.05)。 2、独立样本t检验结果显示与对照组相比,实验组血清IDE水平下降(P0.05)。 3、Spearman直线相关分析显示对照组中IDE水平与胰岛素、胰岛素抵抗指数之间有相关性,而在实验组中无相关性。 4、Spearman直线相关分析显示在实验组中,空腹血糖水平与认知功能呈负相关(P0.05)。 5、单因素方差分析显示轻、中、重度组患者之间血清IDE水平无明显统计学差异(P0.05)。结论：胰岛素降解酶水平的下降,与阿尔茨海默病的发生有一定相关性,在阿尔茨海默病患者体内胰岛素降解酶对胰岛素及胰岛素抵抗的调节可能出现障碍。第二部分阿尔茨海默病患者瘦素水平及与糖代谢关系的临床研究目的：探讨阿尔茨海默病患者瘦素水平的变化及瘦素与血糖、胰岛素、胰岛素抵抗之间的关系,为进一步防治阿尔茨海默病提供理论依据。方法：选择32例阿尔茨海默病患者(实验组)和30例正常老年人(对照组),进行MMSE及CDR评分,实验组按照CDR得分再分为轻、中、重度组。两组同时测量身高、体重、空腹血糖、血脂等,采用酶联免疫吸附法和化学发光法分别检测其血清瘦素和胰岛素水平并计算胰岛素抵抗指数及体质量指数,分析瘦素、胰岛素及胰岛素抵抗指数之间的关系,寻找在阿尔茨海默病中瘦素水平及其与胰岛素之间的关系的变化。结果： 1、独立样本t检验结果显示实验组与对照组在胰岛素及胰岛素抵抗指数水平无显著差异(P0.05)。 2、独立样本t检验结果显示与对照组相比,血清瘦素水平明显下降(P0.05)。 3、Spearman直线相关分析结果显示在对照组中瘦素水平与胰岛素、胰岛素抵抗指数之间有相关性,而在病例组中无相关性。 4、单因素方差分析显示不同严重程度的阿尔茨海默病患者之间血清瘦素水平无统计学差异(P0.05)。结论：瘦素水平的下降,与阿尔茨海默病的发生有一定相关性,瘦素可能是AD的保护性因子；在阿尔茨海默病患者体内瘦素与胰岛素及胰岛素抵抗之间的调节作用可能出现障碍。
[Abstract]:Background

Alzheimer ' s disease ( AD ) is the most common type of Alzheimer ' s disease . Therefore , it is helpful to understand the relationship between metabolism - related factors such as insulin , insulin - degrading enzyme and leptin and AD , which can help to understand the pathogenesis of AD and provide new ideas and methods for the treatment and prevention of Alzheimer ' s disease .

the first portion

Study on the levels of blood glucose , insulin and insulin - degrading enzymes in patients with Alzheimer ' s disease

Purpose :

To explore the relationship between Alzheimer ' s disease and blood sugar , insulin and insulin - degrading enzymes and provide theoretical basis for further prevention and treatment of Alzheimer ' s disease .

Method :

The levels of serum insulin - degrading enzyme ( IDE ) and insulin were measured by enzyme - linked immunosorbent assay ( ELISA ) and chemiluminescence method .

Results :

1 . The t - test results of independent samples showed no significant difference in height , body weight , BMI , fasting plasma glucose , total cholesterol , triglyceride , high density lipoprotein , low density lipoprotein , insulin and insulin resistance index ( P0.05 ) .

2 . The t - test results of independent samples showed that the level of serum IDE in experimental group decreased ( P0.05 ) .

The results showed that the level of IDE in the control group was correlated with insulin and insulin resistance index , but there was no correlation in the experimental group .

The results showed that fasting plasma glucose level was negatively correlated with cognitive function in the experimental group ( P0.05 ) .

5 . Single - factor analysis showed that there was no significant difference in serum IDE level between patients with mild , moderate and severe group ( P0.05 ) .

Conclusion :

The decline of insulin - degrading enzyme level is related to the occurrence of Alzheimer ' s disease , and the regulation of insulin - degrading enzyme to insulin and insulin resistance in patients with Alzheimer ' s disease may be impaired .

the second part

A clinical study on the relationship between leptin level and glucose metabolism in patients with Alzheimer ' s disease

Purpose :

To explore the relationship between leptin and insulin resistance in patients with Alzheimer ' s disease and to provide a theoretical basis for further prevention and treatment of Alzheimer ' s disease .

Method :

The levels of leptin , insulin and insulin resistance were measured by enzyme - linked immunosorbent assay and chemiluminescence method , and the relationship between leptin , insulin and insulin resistance index was analyzed . The relationship between leptin , insulin and insulin resistance index was analyzed . The relationship between leptin level and insulin resistance was found in Alzheimer ' s disease .

Results :

1 . The t - test results showed no significant difference between the experimental group and the control group at the insulin and insulin resistance index ( P0.05 ) .

2 . The t - test results of independent samples showed that the serum leptin level decreased significantly compared with the control group ( P0.05 ) .

The results showed that leptin was correlated with insulin and insulin resistance index in the control group , but there was no correlation in case group .

4 . Single - factor analysis showed that there was no significant difference in serum leptin levels between patients with Alzheimer ' s disease ( P0.05 ) .

Conclusion :

The decrease of leptin level is related to the occurrence of Alzheimer ' s disease , and leptin may be a protective factor of AD ;
The regulatory effects between leptin and insulin and insulin resistance in patients with Alzheimer ' s disease may be impaired .
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16

【参考文献】