PDF(Pubmed)
Abstract：
Recent studies show that Alzheimer\'s disease (AD) has many common links with conditions associated with insulin resistance, including neuroinflammation, impaired insulin signaling, oxidative stress, mitochondrial dysfunction and metabolic syndrome. The authors conducted an electronic search for publications in the PubMed/MEDLINE and Google Scholar databases using the keywords \"amyloid beta\", \"Alzheimer type-3-diabetes\", \"intranasal insulin\", \"metformin\", \"type 2 diabetes mellitus\", \"incretins\" and \"PPARy agonists». A systematic literature search was conducted among studies published between 2005 and 2022. The authors used the following inclusion criteria: 1) Subjects who received therapy for AD and/or DM2, if the expected result concerned the risk of cognitive decline or the development of dementia; 2) The age of the study participants is > 50 years; 3) The type of studies included in this review were randomized clinical trials, population-based observational studies or case-control studies, prospective cohort studies, as well as reviews and meta-analyses; 4) The included articles were written in English. In recent years, there has been considerable interest in identifying the mechanisms of action of antidiabetic drugs and their potential use in AD. Human studies involving patients with mild cognitive impairment and Alzheimer\'s disease have shown that the administration of certain antidiabetic drugs, such as intranasal insulin, metformin, incretins and thiazolidinediones, can improve cognitive function and memory. The purpose of this study is to evaluate the effectiveness of antidiabetic drugs in the treatment of AD. According to the results of the study, metformin, intranasal insulin, thiazolidinediones and incretins showed a positive effect both in humans and in animal models. Recent studies show that thiazolidinediones can activate pathways in the brain that are regulated by IGF-1; however, rosiglitazone may pose a significant risk of side effects. The results of clinical studies on the use of metformin in AD are limited and contradictory.
摘要：
最近的研究表明，阿尔茨海默病（AD）与胰岛素抵抗相关的疾病有许多共同的联系，包括神经炎症,胰岛素信号受损，氧化应激，线粒体功能障碍和代谢综合征。作者对PubMed/MEDLINE和GoogleScholar数据库中的出版物进行了电子搜索，使用关键字“淀粉样蛋白β”，“阿尔茨海默氏症-3型糖尿病”，“鼻内胰岛素”，\"二甲双胍\",“2型糖尿病”，\"增量蛋白\"和\"PPARy激动剂"。对2005年至2022年发表的研究进行了系统的文献检索。作者使用了以下纳入标准：1）接受AD和/或DM2治疗的受试者，如果预期结果涉及认知能力下降或发展为痴呆的风险；2）研究参与者的年龄为50岁；3）本综述中包含的研究类型为随机临床试验，基于人群的观察性研究或病例对照研究，前瞻性队列研究，以及评论和荟萃分析；4)收录的文章用英语写。近年来,人们对确定抗糖尿病药物的作用机制及其在AD中的潜在用途有相当大的兴趣。涉及轻度认知障碍和阿尔茨海默病患者的人体研究表明，服用某些抗糖尿病药物，如鼻内胰岛素，二甲双胍,肠促胰岛素和噻唑烷二酮，能提高认知功能和记忆力。这项研究的目的是评估抗糖尿病药物在AD治疗中的有效性。根据研究结果,二甲双胍,鼻内胰岛素，噻唑烷二酮和肠促胰岛素在人类和动物模型中均显示出积极作用。最近的研究表明，噻唑烷二酮可以激活受IGF-1调节的大脑通路；然而，罗格列酮可能带来严重的副作用风险.关于二甲双胍在AD中使用的临床研究结果有限且相互矛盾。
