摘要
目前糖尿病(diabetes mellitus,DM)不仅是一个全球性公共卫生问题,也已成为我国居民的常见病、多发病,其可导致多种并发症。轻度认知功能障碍(mild cognitive impairment,MCI)是阿尔茨海默病(Alzheimer’s disease,AD)发展过程中的一个阶段,是介于正常与痴呆之间的一种过渡状态,发展为AD的可能性很大,严重影响患者的生活质量。已有的研究结果显示2型糖尿病(type 2 diabetes mellitus,T2DM)与MCI密切相关。由于这两种疾病之间存在相互影响和相互作用,有的学者甚至将AD称为“3型糖尿病”。正因如此,T2DM的防治方法和策略是否会对MCI患者产生有利影响,延缓其认知功能的下降,也受到越来越多的关注。特别是降糖药物治疗是否可以改善MCI患者认知功能成为近年来研究的热点,已有许多动物模型和临床研究的试验结果给出了肯定的答案。目前的研究显示胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)具有保护神经元和改善认知功能的作用。GLP-1受体激动剂(GLP-1 receptor agonist)、二肽基肽酶-4抑制剂(DDP-4 inhibitors)此两类可增加体内GLP-1水平的药物已被用于糖尿病的治疗,随着这些药物近年在临床的广泛应用,有越来越多证据表明使用此类药物后T2DM患者的认知功能有明显的改善,故GLP-1类药物有望成为治疗T2DM合并MCI的理想药物。本文针对GLP-1对T2DM合并MCI患者认知功能改善的问题进行综述,以期为进一步认识T2DM、MCI提供新的思路,为其治疗开拓新的方法。
Diabetes mellitus(DM)is not only a global public health issue at present,also has become our country resident common disease,frequently-occurring disease,which can lead to a variety of complications.Mild cognitive impairment(MCI)is a stage in the development of Alzheimer's disease(AD),which is a transitional state between normal and dementia.It can progress to AD.Patients'quality of life is severely affected.Existing research suggests that type 2 diabetes mellitus(T2DM)is closely associated with MCI.Because of the interaction and interdependence between these two diseases,some researchers even refer to AD as"type 3 diabetes".For this reason,more and more attention has been paid to whether T2DM prevention and treatment methods and strategies can have beneficial effects on MCI patients and delay their cognitive decline.In particular,whether hypoglycemic drug therapy can improve the cognitive function in MCI patients has become a research hotspot in recent years,and many animal models and clinical research results have given a positive answer.Recent studies have shown that glucagon-like peptide-1(GLP-1)can protect neurons and improve cognitive function.Glp-1 receptor agonists and DDP-4 inhibitors,which can increase GLP-1 levels in vivo,have been used in the treatment of diabetes.With the widespread clinical application of these drugs in recent years,there is increasing evidence that the cognitive function in patients with T2DM is significantly improved after the use of these drugs.Therefore,GLP-1 drugs are expected to be ideal drugs for the treatment of T2DM complicated by MCI.This article reviews the improvement of cognitive function in patients suffering from T2DM with MCI by using GLP-1,in order to provide a deeper understanding of T2DM and MCI and to explore new approaches for their treatment.
作者
杨蓉
陆媛
于德华
YANG Rong;LU yuan;YU Dehua(Department of General Practice,Yangpu Hospital,Tongji University School of Medicine,Shanghai 200090,China)
出处
《中华全科医学》
2023年第10期1749-1752,共4页
Chinese Journal of General Practice
基金
上海市“医苑新星”青年医学人才培养资助计划([2019]072号)。
