Clinical Study On Relationship Between Insulin Resistance And Mild Cognitive Impairment

Objective:There has been research into relationship between the diabetes and mild cognitive impairment(MCI)or alzheimer disease(AD).However, what is the correlation between insulin resistance(IR)and MCI? What is the aspect of lesion caused by insulin resistance to the cognitive function? What is the extent of danger influencing MCI? It is necessary to conduct clinical research about insulin resistance and mild cognitive impairment.Method:102 clinical insulin resistance patients were made into a group for research.In accord with MCI diagnostic and excluding standards of petersen,they were selected into the MCI and cognitive function normal group.All admitted subjects were evaluated with MMSE, GDS,CMS,ADL and other evaluation.The patient' s fasting plasma glucose and fasting insulin and insulin sensitivity index(ISI)were tested; blood routine,glycated hemoglobin,blood fat,liver and kidney function, blood pressure,body mass index(BMI),liver color ultrasonic diagram, electrocardiogram,Cranial Computed tomography was carried out.50 physical examinees with age and sex corresponding to that of the research group were made into a reference group.Group t testing is made to all data,as well as analysis of covariance,x~2 test,lineal correlative and logistic regressive analysis,so as to define relationship between the indices of the observation and MCI.Results:1.Insulin resistance patient has the occurrence rate of MCI(30.4%)obviously higher than the non-insulin-resistance patient(14.0%).2.Compared with the patient of the normal cognitive function,MCI patient has more serious insulin resistance and higher fasting insulin levels(P＜0.01);ISI of MCI and Insulin resistance patients presents significant positive correlation (P＜0.01),and as to fasting insulin levels,it presents significant negative correlation(P＜0.01);the patient of serious insulin resistance has the occurrence rate of MCI(37.3%)obviously higher than the mild insulin resistance group(19.6%).3.The insulin resistance group diabetics have the occurrence rate of MCI(36.6%)obviously higher than the non-diabetic(16.1%);the patient with poor control over the diabetes blood glucose has the occurrence rate of MCI(48.6%)obviously higher than the patient with good control over the diabetes blood glucose(25.0%). 4.Lesion of insulin resistance upon the patient' s cognitive function was mainly reflected in the directive memory,association study,image free memory,meaningless graph recognition,human figure feature associated memory,etc.(P＜0.05),indicating that insulin resistance imposes impact upon various aspects of the cognitive function.5.In logistic regressive analysis,the last to enter the equation was the degree of education, ISI,fasting insulin levels,hypertension and glycated hemoglobin.Among these,high degree of education was the protective factor of MCI,while insulin resistance,high level of insulin,hypertension and higher glucose were the independent dangerous factors of MCI.Conclusions:1.The insulin resistance patient has the occurrence rate of MCI obviously higher than the non-insulin-resistance patient;compared with the patient of the normal cognitive function,MCI patient has more serious insulin resistance and higher fasting insulin levels;ISI of MCI and insulin resistance patients presents significant positive correlation,and as to fasting insulin levels,it presents significant negative correlation.Insulin resistance plays a key role in occurrence and development of MCI,providing new thought about interference of MCI.2.Lesion of insulin resistance upon the patient' s cognitive function was mainly reflected in the directive memory,association study,image free memory,meaningless graph recognition,human figure feature associated memory,etc,indicating that insulin resistance imposes impact upon various aspects of the cognitive function.3.Insulin resistance,high level of insulin,hypertension and higher glucose are the independent dangerous factors of MCI,while high degree of education is the protective factor of MCI.Therefore,active interference into high level of insulin,higher glucose and hypertension and improvement of sensitivity of the high insulin will benefit cognitive function of the insulin resistance patient.