title: Steroid-induced elevation of glucose in Alzheimer's disease: relationship to gender, apolipoprotein E genotype and cognition.
abstract: 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.
authors.affiliation: Department of Neurology, Georgetown University Medical Center, 1Bles Building, 3800 Reservoir Road NW, Washington, DC 20007, USA. psa@georgetown.edu
authors.forename: P S
authors.initials: PS
authors.lastname: Aisen
authors.forename: J D
authors.initials: JD
authors.lastname: Berg
authors.forename: S
authors.initials: S
authors.lastname: Craft
authors.forename: E R
authors.initials: ER
authors.lastname: Peskind
authors.forename: M
authors.initials: M
authors.lastname: Sano
authors.forename: L
authors.initials: L
authors.lastname: Teri
authors.forename: R A
authors.initials: RA
authors.lastname: Mulnard
authors.forename: R G
authors.initials: RG
authors.lastname: Thomas
authors.forename: L J
authors.initials: LJ
authors.lastname: Thal
mesh_terms: 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
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D001786:Blood Glucose; D010919:Placebos; D011241:Prednisone