Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/27995
標題: 神經性退化疾病患者其抗胰島素程度及荷爾蒙相關之研究
The Correlation of Insulin Resistance levels and Hormone Concentrations in Neurodegenerative Patients
作者: 陳俞廷
Chen, Yu-Ting
關鍵字: Alzheimer 's disease
阿茲海默症
Parkinson's Disease
Insulin Resistance
Hormones
帕金森氏症
胰島素阻抗性
荷爾蒙
出版社: 運動與健康管理研究所
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摘要: 本研究主要目的為探究神經性退化疾病患者其胰島素阻抗程度,以及其血液中荷爾蒙濃度之差異,募集自彰化縣基督教醫院共190名受試者,囊括女性101人以及男性89人,經神經專科醫師診斷為阿茲海默症患者(Alzheimer’s disease)96名(含女性53人與男性43人)與帕金森氏症患者(Parkinson disease)102名(含女性52人與男性50人),其中同時罹患阿滋海默症與帕金森氏症8名(分別為女性4人與男性4人),經十二小時禁食後進行採血並進一步分析其血漿中荷爾蒙濃度與血液生化指標之差異。 綜觀研究結果發現,阿茲海默症患者較帕金森氏症患者年齡較長,同時阿茲海默症患者在簡易智能狀態測驗(Mini-Mental Status Examination, MMSE)得分亦較帕金森氏症患者為低,並且不同性別之間雖未存在年齡差異,仍顯示女性在簡易智能狀態測驗的得分較男性低。此外阿茲海默症患者血漿中葡萄糖濃度顯著低於帕金森氏症患者,但不同性別間血漿中葡萄糖濃度未有顯著差異。相較於其他學者研究,本研究之受試者之同半胱胺酸濃度普遍較高,並且男性較女性表現出較高的同半胱胺酸濃度及較低的葉酸濃度。而性荷爾蒙僅在不同性別間表現差異,即使在不同疾病分類下,女性其睪固酮、雌激素、黃體素濃度皆較男性為低,而促黃體素與性荷爾蒙結合球蛋白則較男性為高。 以胰島素阻抗程度對所有受試者進行分類比較,將HOMA score≧2.5定義為高胰島素阻抗程度(HIR)且HOMA score<2.5定義為低胰島素阻抗程度(LIR),研究結果顯示高胰島素阻抗現象者較低胰島素阻抗現象者在簡易智能狀態測驗表現為低,而阿茲海默症患者中較低胰島素阻抗現象者,則血漿中青鈷胺素濃度較高,此外,研究結果亦顯示帕金森氏症患者中較低胰島素阻抗者,則其血漿中睪固酮濃度則較高。 將以上結果合併相關分析與迴歸模型配適歸納出以下結論,神經退化疾病其主要風險因子為年齡與性別,年齡越長及女性性別者則越易有認知功能上的障礙,血漿中睪固酮、雌激素及黃體素濃度亦隨著年齡越長而漸低,促黃體素與性荷爾蒙結合球蛋白則隨著年齡越長而漸增,並且性荷爾蒙在女性性別之改變尤為明顯。此外較高的同型半胱胺酸濃度及較低的氰鈷胺素與葉酸濃度,亦可能對認知功能造成損傷,藉由額外的氰鈷胺素與葉酸補充可能得以降低同半胱胺酸濃度。然而研究結果亦顯示胰島素阻抗程度越高者則在簡易智能狀態檢測之得分越低,推論胰島素阻抗性異常可能造成認知功能的損傷,而本研究中未能直接證實胰島素阻抗性與同半胱胺酸、氰鈷胺素、葉酸及性荷爾蒙之關係。
The purpose of this study was to investigate the influence of insulin resistance level on plasma hormones concentrations in neurodegenerative patients. A hundred and ninety subjects (male n= 89, female n=101) either diagnosed as Alzheimer's disease (AD, n=96; male n=43, female n=53) or Parkinson disease (PD, n=102; male n=50, female n=52) were recruited from Chunghwa Christian Hospital. Fasting blood samples were collected for hormones concentrations and biochemistry markers analysis. The results showed that AD patients were higher in age and lower in Mini-Mental Status Examination (MMSE) score and plasma glucose concentration than PD patients. Female patients were lower in MMSE score, plasma homocysteine, testosterone, estrogen and progesterone concentrations, and higher in plasma folate, luteinizing hormone (LH) and sex hormone binding globulin (SHBG) concentrations than that of male patients. We calculated HOMA scores of all subjects and divided into high insulin resistance group (HIR, HOMA score≧2.5) and low insulin sensitivity group (LIR, HOMA score < 2.5). The results indicated that HIR showed a lower MMSE score than LIR. AD patients with LIR showed higher plasma Vit B12 concentrations and PD patients with LIR showed higher testosterone concentrations. According correlation and regression analysis, the main risk factors of neurodegenerative diseases were age and sex. The older age and female subjects tended to have lower MMSE score. The plasma testosterone, plasma estrogen, plasma progesterone concentrations were lower when the subjects were getting older. On contrary, the LH and SHBG concentration were getting higher when subject were aged. The higher plasma homocysteine concentration and lower plasma Vit B12 and folate concentrations tended to have lower MMSE score. However, the current results were failed to indentify the correlation between insulin resistance and plasma homocysteine, Vit B12, folate and sex hormones.
URI: http://hdl.handle.net/11455/27995
其他識別: U0005-1108200917030300
文章連結: http://www.airitilibrary.com/Publication/alDetailedMesh1?DocID=U0005-1108200917030300
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