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Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study.
BMJ 1997; 315(7115):1045-9BMJ

Abstract

OBJECTIVE

To determine the association between features of the insulin resistance syndrome and Alzheimer's disease.

DESIGN

Cross sectional population based study.

SUBJECTS

980 people aged 69 to 78 (349 men, 631 women).

SETTING

Population of Kuopio, eastern Finland.

MAIN OUTCOME MEASURES

Presence of features of the insulin resistance syndrome and diagnosis of Alzheimer's disease by detailed neurological and neuropsychological evaluation.

RESULTS

46 (4.7%) subjects were classified as having probable or possible Alzheimer's disease. In univariate analyses, apolipoprotein E4 phenotype (odds ratio; 95% confidence interval 3.24: 1.77 to 5.92), age (1.16; 1.05 to 1.29), low level of education (0.82; 0.72 to 0.93), low total cholesterol concentration (0.77; 0.59 to 1.00), high systolic blood pressure (1.01; 1.00 to 1.03), high fasting and 2 hour plasma glucose concentrations (1.11; 1.01 to 1.23 and 1.08; 1.03 to 1.13, respectively), high fasting and 2 hour insulin concentrations (1.05; 1.02 to 1.08 and 1.003; 1.00 to 1.01, respectively), and abnormal glucose tolerance (1.86; 1.23 to 2.80) were significantly associated with Alzheimer's disease. In multivariate analysis including apolipoprotein E4 phenotype, age, education, systolic blood pressure, total cholesterol concentration, fasting glucose concentration, and insulin concentration, apolipoprotein E4 phenotype, age, education, total cholesterol, and insulin were significantly associated with Alzheimer's disease. In 532 non-diabetic subjects without the e4 allele hyperinsulinaemia was associated with an increased risk for Alzheimer's disease (prevalence of disease 7.5% v 1.4% in normoinsulinaemic subjects, P = 0.0004). In contrast, in the 228 with the e4 allele hyperinsulinaemia had no effect on the risk of disease (7.0% v 7.1%, respectively).

CONCLUSION

Features of the insulin resistance syndrome are associated with Alzheimer's disease independently of apolipoprotein E4 phenotype.

Authors+Show Affiliations

Department of Medicine, Kuopio University Hospital, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9366728

Citation

Kuusisto, J, et al. "Association Between Features of the Insulin Resistance Syndrome and Alzheimer's Disease Independently of Apolipoprotein E4 Phenotype: Cross Sectional Population Based Study." BMJ (Clinical Research Ed.), vol. 315, no. 7115, 1997, pp. 1045-9.
Kuusisto J, Koivisto K, Mykkänen L, et al. Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study. BMJ. 1997;315(7115):1045-9.
Kuusisto, J., Koivisto, K., Mykkänen, L., Helkala, E. L., Vanhanen, M., Hänninen, T., ... Laakso, M. (1997). Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study. BMJ (Clinical Research Ed.), 315(7115), pp. 1045-9.
Kuusisto J, et al. Association Between Features of the Insulin Resistance Syndrome and Alzheimer's Disease Independently of Apolipoprotein E4 Phenotype: Cross Sectional Population Based Study. BMJ. 1997 Oct 25;315(7115):1045-9. PubMed PMID: 9366728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study. AU - Kuusisto,J, AU - Koivisto,K, AU - Mykkänen,L, AU - Helkala,E L, AU - Vanhanen,M, AU - Hänninen,T, AU - Kervinen,K, AU - Kesäniemi,Y A, AU - Riekkinen,P J, AU - Laakso,M, PY - 1997/11/21/pubmed PY - 1997/11/21/medline PY - 1997/11/21/entrez SP - 1045 EP - 9 JF - BMJ (Clinical research ed.) JO - BMJ VL - 315 IS - 7115 N2 - OBJECTIVE: To determine the association between features of the insulin resistance syndrome and Alzheimer's disease. DESIGN: Cross sectional population based study. SUBJECTS: 980 people aged 69 to 78 (349 men, 631 women). SETTING: Population of Kuopio, eastern Finland. MAIN OUTCOME MEASURES: Presence of features of the insulin resistance syndrome and diagnosis of Alzheimer's disease by detailed neurological and neuropsychological evaluation. RESULTS: 46 (4.7%) subjects were classified as having probable or possible Alzheimer's disease. In univariate analyses, apolipoprotein E4 phenotype (odds ratio; 95% confidence interval 3.24: 1.77 to 5.92), age (1.16; 1.05 to 1.29), low level of education (0.82; 0.72 to 0.93), low total cholesterol concentration (0.77; 0.59 to 1.00), high systolic blood pressure (1.01; 1.00 to 1.03), high fasting and 2 hour plasma glucose concentrations (1.11; 1.01 to 1.23 and 1.08; 1.03 to 1.13, respectively), high fasting and 2 hour insulin concentrations (1.05; 1.02 to 1.08 and 1.003; 1.00 to 1.01, respectively), and abnormal glucose tolerance (1.86; 1.23 to 2.80) were significantly associated with Alzheimer's disease. In multivariate analysis including apolipoprotein E4 phenotype, age, education, systolic blood pressure, total cholesterol concentration, fasting glucose concentration, and insulin concentration, apolipoprotein E4 phenotype, age, education, total cholesterol, and insulin were significantly associated with Alzheimer's disease. In 532 non-diabetic subjects without the e4 allele hyperinsulinaemia was associated with an increased risk for Alzheimer's disease (prevalence of disease 7.5% v 1.4% in normoinsulinaemic subjects, P = 0.0004). In contrast, in the 228 with the e4 allele hyperinsulinaemia had no effect on the risk of disease (7.0% v 7.1%, respectively). CONCLUSION: Features of the insulin resistance syndrome are associated with Alzheimer's disease independently of apolipoprotein E4 phenotype. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/9366728/Association_between_features_of_the_insulin_resistance_syndrome_and_Alzheimer's_disease_independently_of_apolipoprotein_E4_phenotype:_cross_sectional_population_based_study_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=9366728 DB - PRIME DP - Unbound Medicine ER -