Associação da demência com intolerância à glicose e diabetes mellitus em função da presença ou não da resistência insulínica e marcadores inflamatórios em idosos / Association of dementia with impaired glucose tolerance and diabetes mellitus in fuction of insulin resistance and inflammatory markers in the elderly

AUTOR(ES)

Renata Freitas Nogueira Salles

DATA DE PUBLICAÇÃO

2010

RESUMO

Introduction: Type 2 Diabetes (T2D) and dementia are highly prevalent diseases among the elderly population. Studies have been evincing that type 2 diabetes are associated with cognitive impairment and also shows a high risk for vascular dementia and for Alzheimers disease. Studies suggest that elderly people with impaired glucose tolerance (IGT) present cognitive loss, and the hyperinsulinemia seems to explain the cognitive deficit in those patients. Objective: To evaluate the presence of cognitive alterations compared to the normal and a possible association of insulin resistance (IR), metabolic syndrome (MS), inflammatory markers and adiponectin in T2D elderly and IGT; to diagnose dementia among patients with cognitive alteration by neuropsychological examination. Patient and Methods: 140 patients with ages between 65 and 86 years were studied 107 of whom were women and classified in 3 groups according to GTT: Normal glucose tolerance (NGT), IGT and T2D. Anthropometric measurements and analyses of glucose and insulin, A1c, total cholesterol and fractions, adiponectin, TNF-alpha and IL-6, were performed in this patients. Cognitive function was measured by mini-mental state examination, clock drawing and verbal fluency test. The patients with cognitive impairment were submitted to neuropsychological battery. Results: The groups were comparable in relation to age, gender and level of education. We did not find statistical differences among the groups in relation to the presence of HA, BMI, waist and inflammatory markers. The presence of MS and IR was increased in the IGT and T2D groups. Patients with IR had high IL-6 and TNF-a and low adiponectin. In the neuropsychological battery, 42 subjects were below the expected for their age and level of education, and, of these, 33 presented cognitive alteration. There was not statistical significance among patients with cognitive deficit the presence of insulin resistance measured by HOMA-IR, adiponectin and inflammatory markers. Patients with cognitive impairment showed poorer performance in immediate and delayed recall of a word list, recognition test and Weschelers memory logic. Conclusion: T2D and IGT were not associated with impaired cognitive function. No difference in insulin resistance, metabolic syndrome, and inflammatory markers has been seen between normal patients and patients with impairment cognitive

ASSUNTO(S)

dementia impaired glucose tolerance elderly insulin resistance resistência a insulina inflamação diabetes mellitus adiponectina inflammation diabetes mellitus intolerância à glicose adiponectina idosos demência

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