胰岛素抵抗与卒中后认知障碍研究进展
Research Progress on Insulin Resistance and Post-Stroke Cognitive Impairment
DOI: 10.12677/acm.2025.15103014, PDF,   
作者: 闫 冰, 张金彪*:威海市立医院神经内科,山东 威海
关键词: 胰岛素抵抗卒中后认知障碍Insulin Resistance Post-Stroke Cognitive Impairment
摘要: 胰岛素抵抗(Insulin Resistance, IR)是一种代谢综合征的核心病理机制,其对大脑糖代谢也产生一定影响。卒中后认知障碍(Post-Stroke Cognitive Impairment, PSCI)是脑卒中患者常见的并发症,极大影响老年人生活质量。研究发现,胰岛素抵抗与脑卒中认知障碍密切相关,本文系统综述IR在PSCI中的病理机制、临床证据及干预策略,旨在为临床防治提供理论依据。
Abstract: Insulin resistance is a core pathological mechanism of metabolic syndrome, and it also has a certain effect on brain glucose metabolism. Post-stroke cognitive impairment (PSCI) is a common complication of stroke patients, which greatly affects the quality of life of the elderly. It is found that insulin resistance is closely related to cognitive impairment of stroke. This paper systematically reviews the pathological mechanism, clinical evidence and intervention strategies of IR in PSCI, aiming at providing theoretical basis for clinical prevention and treatment.
文章引用:闫冰, 张金彪. 胰岛素抵抗与卒中后认知障碍研究进展[J]. 临床医学进展, 2025, 15(10): 2311-2316. https://doi.org/10.12677/acm.2025.15103014

参考文献

[1] Gallucci, L., Sperber, C., Guggisberg, A.G., Kaller, C.P., Heldner, M.R., Monsch, A.U., et al. (2024) Post-Stroke Cognitive Impairment Remains Highly Prevalent and Disabling Despite State-of-the-Art Stroke Treatment. International Journal of Stroke, 19, 888-897. [Google Scholar] [CrossRef] [PubMed]
[2] Ma, L. and Li, Y. (2017) Cognitive Function and Insulin Resistance in Elderly Patients with Type 2 Diabetes. Neurological Research, 39, 259-263. [Google Scholar] [CrossRef] [PubMed]
[3] Cowan, A.J., Allen, C., Barac, A., et al. (2018) Global Burden of Multiple Myeloma: A Systematic Analysis for the Global Burden of Disease Study 2016. JAMA Oncology, 4, 1221-1227.
[4] Rist, P.M., Chalmers, J., Arima, H., Anderson, C., MacMahon, S., Woodward, M., et al. (2013) Baseline Cognitive Function, Recurrent Stroke, and Risk of Dementia in Patients with Stroke. Stroke, 44, 1790-1795. [Google Scholar] [CrossRef] [PubMed]
[5] Ding, M., Xu, Y., Wang, Y., Li, P., Mao, Y., Yu, J., et al. (2019) Predictors of Cognitive Impairment after Stroke: A Prospective Stroke Cohort Study. Journal of Alzheimers Disease, 71, 1139-1151. [Google Scholar] [CrossRef] [PubMed]
[6] Tatemichi, T.K., Paik, M., Bagiella, E., Desmond, D.W., Pirro, M. and Hanzawa, L.K. (1994) Dementia after Stroke Is a Predictor of Long-Term Survival. Stroke, 25, 1915-1919. [Google Scholar] [CrossRef] [PubMed]
[7] Nudo, R.J. (2013) Recovery after Brain Injury: Mechanisms and Principles. Frontiers in Human Neuroscience, 7, Article 887. [Google Scholar] [CrossRef] [PubMed]
[8] Zhang, X. and Bi, X. (2020) Post-Stroke Cognitive Impairment: A Review Focusing on Molecular Biomarkers. Journal of Molecular Neuroscience, 70, 1244-1254. [Google Scholar] [CrossRef] [PubMed]
[9] Tack, R.W.P., Amboni, C., van Nuijs, D., Pekna, M., Vergouwen, M.D.I., Rinkel, G.J.E., et al. (2023) Inflammation, Anti-Inflammatory Interventions, and Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis of Human and Animal Studies. Translational Stroke Research, 16, 535-546. [Google Scholar] [CrossRef] [PubMed]
[10] Doyle, K.P., Quach, L.N., Solé, M., Axtell, R.C., Nguyen, T.V., Soler-Llavina, G.J., et al. (2015) B-Lymphocyte-Mediated Delayed Cognitive Impairment Following Stroke. The Journal of Neuroscience, 35, 2133-2145. [Google Scholar] [CrossRef] [PubMed]
[11] Ihara, M. and Kalaria, R.N. (2014) Understanding and Preventing the Development of Post-Stroke Dementia. Expert Review of Neurotherapeutics, 14, 1067-1077. [Google Scholar] [CrossRef] [PubMed]
[12] Pantoni, L. (2010) Cerebral Small Vessel Disease: From Pathogenesis and Clinical Characteristics to Therapeutic Challenges. The Lancet Neurology, 9, 689-701. [Google Scholar] [CrossRef] [PubMed]
[13] Debette, S. and Markus, H.S. (2010) The Clinical Importance of White Matter Hyperintensities on Brain Magnetic Resonance Imaging: Systematic Review and Meta-Analysis. British Medical Journal, 341, c3666. [Google Scholar] [CrossRef] [PubMed]
[14] Ciancarelli, I., Morone, G., Iosa, M., Cerasa, A., Calabrò, R.S., Iolascon, G., et al. (2022) Influence of Oxidative Stress and Inflammation on Nutritional Status and Neural Plasticity: New Perspectives on Post-Stroke Neurorehabilitative Outcome. Nutrients, 15, Article 108. [Google Scholar] [CrossRef] [PubMed]
[15] Li, P., Stetler, R.A., Leak, R.K., Shi, Y., Li, Y., Yu, W., et al. (2018) Oxidative Stress and DNA Damage after Cerebral Ischemia: Potential Therapeutic Targets to Repair the Genome and Improve Stroke Recovery. Neuropharmacology, 134, 208-217. [Google Scholar] [CrossRef] [PubMed]
[16] Ghowsi, M., Qalekhani, F., Farzaei, M.H., Mahmudi, F., Yousofvand, N. and Joshi, T. (2021) Inflammation, Oxidative Stress, Insulin Resistance, and Hypertension as Mediators for Adverse Effects of Obesity on the Brain: A Review. BioMedicine, 11, 13-22. [Google Scholar] [CrossRef] [PubMed]
[17] Lee, S., Park, S. and Choi, C.S. (2022) Insulin Resistance: From Mechanisms to Therapeutic Strategies. Diabetes & Metabolism Journal, 46, 15-37. [Google Scholar] [CrossRef] [PubMed]
[18] Su, F., Shu, H., Ye, Q., Wang, Z., Xie, C., Yuan, B., et al. (2016) Brain Insulin Resistance Deteriorates Cognition by Altering the Topological Features of Brain Networks. NeuroImage: Clinical, 13, 280-287. [Google Scholar] [CrossRef] [PubMed]
[19] 王富军, 丁海霞. 中国老年2型糖尿病胰岛素抵抗诊疗专家共识(2022版)解读[J]. 河北医科大学学报, 2024, 45(11): 1241-1246.
[20] Simental-Mendía, L.E., Rodríguez-Morán, M. and Guerrero-Romero, F. (2008) The Product of Fasting Glucose and Triglycerides as Surrogate for Identifying Insulin Resistance in Apparently Healthy Subjects. Metabolic Syndrome and Related Disorders, 6, 299-304. [Google Scholar] [CrossRef] [PubMed]
[21] Sánchez-García, A., Rodríguez-Gutiérrez, R., Mancillas-Adame, L., González-Nava, V., Díaz González-Colmenero, A., Solis, R.C., et al. (2020) Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. International Journal of Endocrinology, 2020, 1-7. [Google Scholar] [CrossRef] [PubMed]
[22] Akhtar, A. and Sah, S.P. (2020) Insulin Signaling Pathway and Related Molecules: Role in Neurodegeneration and Alzheimer’s Disease. Neurochemistry International, 135, Article 104707. [Google Scholar] [CrossRef] [PubMed]
[23] Gasecka, A., Siwik, D., Gajewska, M., Jaguszewski, M.J., Mazurek, T., Filipiak, K.J., et al. (2020) Early Biomarkers of Neurodegenerative and Neurovascular Disorders in Diabetes. Journal of Clinical Medicine, 9, Article 2807. [Google Scholar] [CrossRef] [PubMed]
[24] Zhao, F., Siu, J.J., Huang, W., Askwith, C. and Cao, L. (2019) Insulin Modulates Excitatory Synaptic Transmission and Synaptic Plasticity in the Mouse Hippocampus. Neuroscience, 411, 237-254. [Google Scholar] [CrossRef] [PubMed]
[25] Gómez-Benito, M., Granado, N., García-Sanz, P., Michel, A., Dumoulin, M. and Moratalla, R. (2020) Modeling Parkinson’s Disease with the Alpha-Synuclein Protein. Frontiers in Pharmacology, 11, Article 356. [Google Scholar] [CrossRef] [PubMed]
[26] Malik, S.A., Acharya, J.D., Mehendale, N.K., Kamat, S.S. and Ghaskadbi, S.S. (2019) Pterostilbene Reverses Palmitic Acid Mediated Insulin Resistance in HepG2 Cells by Reducing Oxidative Stress and Triglyceride Accumulation. Free Radical Research, 53, 815-827. [Google Scholar] [CrossRef] [PubMed]
[27] Deng, X., Liu, Z., Wang, C., Li, Y. and Cai, Z. (2017) Insulin Resistance in Ischemic Stroke. Metabolic Brain Disease, 32, 1323-1334. [Google Scholar] [CrossRef] [PubMed]
[28] Rusinek, H., Ha, J., Yau, P.L., Storey, P., Tirsi, A., Tsui, W.H., et al. (2015) Cerebral Perfusion in Insulin Resistance and Type 2 Diabetes. Journal of Cerebral Blood Flow & Metabolism, 35, 95-102. [Google Scholar] [CrossRef] [PubMed]
[29] Livingston, J.M., McDonald, M.W., Gagnon, T., Jeffers, M.S., Gomez-Smith, M., Antonescu, S., et al. (2020) Influence of Metabolic Syndrome on Cerebral Perfusion and Cognition. Neurobiology of Disease, 137, Article 104756. [Google Scholar] [CrossRef] [PubMed]
[30] Fahed, G., Aoun, L., Bou Zerdan, M., Allam, S., Bou Zerdan, M., Bouferraa, Y., et al. (2022) Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. International Journal of Molecular Sciences, 23, Article 786. [Google Scholar] [CrossRef] [PubMed]