title: [Achetylcholinesterase (AChE) inhibition and serum lipokines in Alzheimer's disease: friend or foe?].
abstract: Throughout the natural progression of Alzheimer's disease (AD), the body mass index (BMI) decreases. This is believed to be brought on by the disturbance in the central lipid metabolism, but the exact mechanism is yet unknown. Adipokines (adiponectin, leptin), hormones produced by the adipose tissue, change glucose and lipid metabolism, and have an anorectic effect through increasing energy consumption in the hypothalamus. The goal of our study was to examine donepezil - an acetylcholinesterase inhibitor (AChEI) currently used in AD therapy -, and to what degree it influences the serum adipokine levels and metabolic parameters of AD patients. During the self-evaluation of 26 clinically diagnosed mild to moderate AD patients, therapy with 10 mg/day donepezil was started according to current protocols. We measured serum adiponectin, leptin, LDL, HDL, trigliceride levels, and BMI and ApoE polymorphism at the beginning of our study, and at 3 and 6-months intervals respectively. All data were analyzed with SPSS 17. In comparison with pre-donepezil therapy values, at the third month interval serum adiponectin levels showed an increasing and leptin levels a decreasing tendency. At the six month interval, adiponectin levels significantly increased (p=0.007), leptin levels decreased (p=0.013), BMI (p=0.001) and abdominal circumference (p=0.017) was significantly lower at 6 months as compared to control values. We did not observe any changes in the lipid profile, and ApoE4 allele carrying showed no association with the parameters. To our knowledge, we are the first to publish that AChEI therapy with donepezil alters lipokine levels, which positively influences the currently known pathomechanism and numerous risk factors of AD. The AChEI treatment-induced weight loss should be considered in the long-term therapy of AD patients.
authors.affiliation: Pszichiátriai Klinika, Szegedi Tudományegyetem, Szeged, Hungary. kovacs.janos@med.u-szeged.hu
authors.forename: Janos
authors.initials: J
authors.lastname: Kovacs
authors.forename: Magdolna
authors.initials: M
authors.lastname: Pakaski
authors.forename: Anna
authors.initials: A
authors.lastname: Juhasz
authors.forename: Agnes
authors.initials: A
authors.lastname: Feher
authors.forename: Gergely
authors.initials: G
authors.lastname: Drotos
authors.forename: Csilla Orsike
authors.initials: CO
authors.lastname: Fazekas
authors.forename: Tamas Laszlo
authors.initials: TL
authors.lastname: Horvath
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Janka
authors.forename: Janos
authors.initials: J
authors.lastname: Kalman
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D001057:Apolipoproteins E / Q000235:genetics; D001066:Appetite; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006814:Hungary; D007189:Indans / Q000008:administration & dosage / Q000627:therapeutic use*; D020738:Leptin / Q000097:blood; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use; D010045:Outpatients; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D054392:Adipokines; D052242:Adiponectin; D001057:Apolipoproteins E; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002800:Cholinesterase Inhibitors; D007189:Indans; D020738:Leptin; D018697:Nootropic Agents; D010880:Piperidines; D014280:Triglycerides; D000077265:Donepezil