Steroid-induced elevation of glucose in Alzheimer's disease: relationship to gender, apolipoprotein E genotype and cognition.
Glucose and insulin may play an important role in the pathophysiology and symptomatology of Alzheimers disease (AD), and prior studies suggest interactions among glucose, insulin, gender and apolipoprotein E genotype. We analyzed the relationship between steroid-induced glucose elevation and gender, presence of the apolipoprotein E epsilon 4 (APOE-4) allele and cognition using data from a multicenter trial of prednisone therapy in AD. The low-dose prednisone regimen (initial dose: 20 mg/day, maintenance dose: 10 mg/day) caused a moderate increase in random blood glucose (mean post-baseline glucose 115 mg/dl). There was a significant interaction between rise in glucose, gender and presence of the APOE-4 allele. There was no important relationship between glucose and cognitive function at baseline or with prednisone treatment. Meta-analysis including data from three other AD trials showed a small influence of random blood glucose on cognitive scores. These results support a relationship between gender, apolipoprotein E genotype and glucose metabolism, but do not indicate that mild changes in glucose have an important impact on cognitive function.
Aisen
P S
PS
Department of Neurology, Georgetown University Medical Center, 1Bles Building, 3800 Reservoir Road NW, Washington, DC 20007, USA. psa@georgetown.edu
Berg
J D
JD
Craft
S
S
Peskind
E R
ER
Sano
M
M
Teri
L
L
Mulnard
R A
RA
Thomas
R G
RG
Thal
L J
LJ
D000483:Alleles; D000544:Alzheimer Disease / Q000097:blood* / Q000188:drug therapy / Q000235:genetics; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D001786:Blood Glucose / Q000032:analysis*; D003071:Cognition; D015914:Estrogen Replacement Therapy; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D010919:Placebos; D011241:Prednisone / Q000008:administration & dosage*; D012727:Sex Characteristics
D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D001786:Blood Glucose; D010919:Placebos; D011241:Prednisone