[Dementia and insulin resistance in patients with diabetes mellitus].
Insulin resistance in peripheral tissues has been suggested to have a crucial role for the pathogenesis of type 2 diabetes. Diabetic people had a 1.5 to 4 fold risk for Alzheimer disease as well as vascular dementia. The insulin resistance (i.e., hyperinsulinemia) in people with impaired glucose tolerance has been one of risk factors for cognitive decline as well as atherosclerotic disease. In contrast, impaired insulin signaling and insulin resistance in brain has been found to be important role for the pathogenesis of Alzheimer disease. Peripheral hyperinsulinemia may link to cerebral insulin resistance, leading to the inhibition of removal of amyloid beta protein and the increase of tau hyperphosphorylation. Several studies have shown that insulin sensitizers (pioglitazone and rosiglitazone) improve cognition and memory in patients with mild Alzheimer disease as well as animal model of Alzheimer disease. Therefore, insulin sensitizers may have one of the effective measures of the prevention of both types of dementia in people with diabetes mellitus.
Section of Endocrinology, Tokyo Metropolitan Geriatric Hospital.
Atsushi
A
Araki
D000818:Animals; D003704:Dementia / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D000077205:Pioglitazone; D012307:Risk Factors; D045162:Thiazolidinediones / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone