胰岛素抵抗与帕金森病痴呆的相关性研究

目的:探讨胰岛素抵抗(IR)对帕金森病(PD)患者发生痴呆的影响。方法:收集141患者进行空腹血糖、空腹胰岛素以及葡萄糖耐量试验(OGTT)测定,采用HOMA法计算胰岛素抵抗指数(HOMA-IR),并应用相关量表对PD患者运动及认知功能障碍程度进行评估,比较分析帕金森病痴呆患者的胰岛素抵抗情况,并应用Logistic回归模型进行分析。结果:141例患者中60例(42.6%)为帕金森病痴呆,其中约63.3%的患者存在IR,明显高于非痴呆帕金森病患者(30.9%)(P<0.05);且在胰岛素抵抗型的PD患者中其痴呆发生率、HOMA-IR、UPDRSⅢ评分以及Hoehn-Yahr分级均明显高于非胰岛素抵抗组(P<0.05);多因素Logistic回归分析发现,IR为PD患者发生痴呆的危险因素(OR=1.550,P=0.004)。结论:IR是PD患者发生痴呆的危险因素之一。

Relationship Between Insulin Resistance and Parkinson's Disease with Dementia

Objective: To explore the relationship between insulin resistance and dementia in patients with Parkinson’s disease.Methods: 141 patients with Parkinson’s disease were involved in this study.The fasting blood glucose,fasting blood insulin and the oral glucose tolerance were detected.The insulin resistance index was also calculated by HOMA formula.Furthermore,the cognitive and motor function impairments were also estimated by assessment scales related to Parkinson’s disease.In addition,the logistic regression analysis was used to analyze the insulin resistance in patients with Parkinson’s disease dementia.Results: Of the all patients,42.6%(60/141) were Parkinson’s disease with dementia,including 38 patients with insulin resistance(63.3%),which were less common in the patients without dementia(30.9%)(P <0.05).Meanwhile,the rate of dementia,HOMA-IR score,UPDRSⅢ score and Hoehn-Yahr scale in group with Parkinson’s disease and dementia were all significantly higher than those in group without dementia(P < 0.05).Moreover,multiple logistic regression analysis showed that the HOMA-IR was a risk factor for dementia in Parkinson’s disease.Conclusion: It suggests that insulin resistance may be a high risk factor for dementia in Parkinson’s disease.