胰岛素抵抗和血压控制对认知结果的影响
Chenyu Fan1, Xuan Wang2,3, Liyuan Tao4
1Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, State Key Laboratory of Vascular Homeostasis and Remodeling, National Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University, Beijing, China (C.F., L.J., Q.S., H.W., Y.S., T.C., Y.X., J.W., M.X.).
密集的血压治疗有利于胰岛素抵抗高血压患者,降低痴呆风险. 这种效应可能由血甘糖基胺水平介导.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 胰岛素抵抗 (IR) 对接受密集血压治疗的高血压患者的认知结果的影响尚未完全理解.
- 调解这种关系的特定循环代谢物需要识别.
研究的目的:
- 研究胰岛素抵抗如何影响高血压个体对密集的静脉血压治疗的认知反应.
- 在IR和认知衰退之间的关系中识别潜在的循环代谢物媒介.
主要方法:
- 综合性血压干预试验 (SPRINT) 的后期分析,涉及7427名高血压参与者.
- 评估认知结果 (可能的痴呆症) 和白质超强度使用Cox模型和混合模型在不同的甘油三糖 (TyG) 水平.
- 门德尔的随机化分析,以探索循环代谢物的调解效应.
主要成果:
- 强化治疗 (<120 mm Hg) 显著降低了痴呆风险,并减缓了白质超强度进展在参与者高IR (TyG>9.07) 的参与者.
- 调解分析揭示了一种途径,即TyG指数通过血甘基胺水平影响痴呆风险,解释了大约10.8%的效应.
结论:
- 在高血压患者中,强化血压控制 (<120 mm Hg) 提供了比标准控制更大的认知益处.
- 甘油三糖 (TyG) 指数似乎改变了治疗对认知衰退的影响,可能是通过糖基胺调解.
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