title: Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study.
abstract: OBJECTIVE
  To determine the association between features of the insulin resistance syndrome and Alzheimer's disease.
  
  
  METHODS
  Cross sectional population based study.
  
  
  METHODS
  980 people aged 69 to 78 (349 men, 631 women).
  
  
  METHODS
  Population of Kuopio, eastern Finland.
  
  
  METHODS
  Presence of features of the insulin resistance syndrome and diagnosis of Alzheimer's disease by detailed neurological and neuropsychological evaluation.
  
  
  RESULTS
  46 (4.7%) subjects were classified as having probable or possible Alzheimer's disease. In univariate analyses, apolipoprotein E4 phenotype (odds ratio; 95% confidence interval 3.24: 1.77 to 5.92), age (1.16; 1.05 to 1.29), low level of education (0.82; 0.72 to 0.93), low total cholesterol concentration (0.77; 0.59 to 1.00), high systolic blood pressure (1.01; 1.00 to 1.03), high fasting and 2 hour plasma glucose concentrations (1.11; 1.01 to 1.23 and 1.08; 1.03 to 1.13, respectively), high fasting and 2 hour insulin concentrations (1.05; 1.02 to 1.08 and 1.003; 1.00 to 1.01, respectively), and abnormal glucose tolerance (1.86; 1.23 to 2.80) were significantly associated with Alzheimer's disease. In multivariate analysis including apolipoprotein E4 phenotype, age, education, systolic blood pressure, total cholesterol concentration, fasting glucose concentration, and insulin concentration, apolipoprotein E4 phenotype, age, education, total cholesterol, and insulin were significantly associated with Alzheimer's disease. In 532 non-diabetic subjects without the e4 allele hyperinsulinaemia was associated with an increased risk for Alzheimer's disease (prevalence of disease 7.5% v 1.4% in normoinsulinaemic subjects, P = 0.0004). In contrast, in the 228 with the e4 allele hyperinsulinaemia had no effect on the risk of disease (7.0% v 7.1%, respectively).
  
  
  CONCLUSIONS
  Features of the insulin resistance syndrome are associated with Alzheimer's disease independently of apolipoprotein E4 phenotype.
authors.affiliation: Department of Medicine, Kuopio University Hospital, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Kuusisto
authors.forename: K
authors.initials: K
authors.lastname: Koivisto
authors.forename: L
authors.initials: L
authors.lastname: Mykkänen
authors.forename: E L
authors.initials: EL
authors.lastname: Helkala
authors.forename: M
authors.initials: M
authors.lastname: Vanhanen
authors.forename: T
authors.initials: T
authors.lastname: Hänninen
authors.forename: K
authors.initials: K
authors.lastname: Kervinen
authors.forename: Y A
authors.initials: YA
authors.lastname: Kesäniemi
authors.forename: P J
authors.initials: PJ
authors.lastname: Riekkinen
authors.forename: M
authors.initials: M
authors.lastname: Laakso
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000235:genetics*; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology / Q000235:genetics; D007333:Insulin Resistance / Q000235:genetics*; D016015:Logistic Models; D008297:Male; D010641:Phenotype; D012307:Risk Factors
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E