Insulin metabolism in Alzheimer’s disease differs according to apolipoprotein E genotype and gender
Abstract
Higher fasting plasma insulin levels and reduced CSF-to-plasma insulin ratios, suggestive of insulin resistance, have been observed in patients with Alzheimer's disease (AD) who do not possess an apolipoprotein E (APOE)-epsilon4 allele. We examined the relationship of APOE and gender to peripheral insulin action and hyperinsulinemic memory facilitation in patients with AD using a sensitive measure of insulin-mediated glucose disposal. Participants were 32 patients with AD (9 without an epsilon4 allele, 23 with an epsilon4 allele) and 25 healthy age-matched adults (16 without an epsilon4 allele, 9 with an epsilon4 allele). AD subjects without an epsilon4 allele had significantly lower insulin-mediated glucose disposal rates than AD patients with an epsilon4 allele (p < 0.03), or than normal adults without an epsilon4 allele (p < 0.02). Female AD subjects showed lower insulin-mediated glucose disposal rates than did male AD subjects (p < 0.02). No significant interaction was observed between APOE group and gender, suggesting that these effects are independent. AD subjects without an epsilon4 allele also showed significant memory facilitation in the hyperinsulinemic condition (p < 0.04), whereas the AD-epsilon4 group did not. Also in the hyperinsulinemic condition, AD patients without an epsilon4 allele had lower insulin levels than patients with an epsilon4 allele (p < 0.02), and women with AD had lower insulin levels than did men with AD despite similar insulin infusion rates and body mass (p < 0.004). No gender or genotype effects were observed in either condition for normal subjects. These results provide in vivo evidence of differences in insulin-mediated energy metabolism between epsilon4 and non-epsilon4 AD, and suggest that defective insulin action may be of particular pathophysiologic significance for patients without an epsilon-4 allele.
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Insulin resistance, a hallmark of diabetes, develops in Alzheimer's brains.
“Recent evidence suggests that insulin resistance, a hallmark of diabetes, develops in Alzheimer’s brains (, 2000; Craft et al., 1999; de la Monte, 2009; Moroz et al., 2008; Pedersen and Flynn, 2004; Razay and Wilcock, 1994; Watson and Craft, 2003).”
From The Aβ oligomer hypothesis for synapse failure and memory loss in Alzheimer’s disease (2011) · cites this paper as Craft et al., 1999
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The pharmacology of amyloid precursor protein processing
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Antidiabetic Drugs in Alzheimer’s Disease and Mild Cognitive Impairment: A Systematic Review
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Obesity and Alcohol Modulate the Effect of Apolipoprotein E Polymorphism on Lipids and Insulin
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Insulin-Degrading Enzyme, Apolipoprotein E, and Alzheimer's Disease
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Molecular and biochemical trajectories from diabetes to Alzheimer’s disease: A critical appraisal
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apoE4 allele and the natural history of cardiovascular risk factors
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Adiponectin as a new paradigm for approaching Alzheimer's disease
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ApoE and cerebral insulin: Trafficking, receptors, and resistance
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Effect of age and glucoregulation on cognitive performance
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Genetic variation in memory functioning
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Effects of Insulin and Octreotide on Memory and Growth Hormone in Alzheimer's Disease
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- Authors
- Craft, S., Asthana, S., Schellenberg, G., Cherrier, M., Baker, L. D., Newcomer, J., Plymate, S., Latendresse, S., Petrova, A., Raskind, M., Peskind, E., Lofgreen, C., & Grimwood, K.
- Affiliations
- University of Washington (US)
- Geriatric Research Education and Clinical Center (US)
- Washington University in St. Louis (US)
- VA Puget Sound Health Care System (US)
- ORCID
- Venue
- Neuroendocrinology
- Publisher
- S. Karger AG
- Published
- 1999
- Volume
- 70
- Issue
- 2
- Pages
- 146-152
- ISSN
- 0028-3835 (ISSN-L)
- 1423-0194
- OpenAlex
- W1967564647
- Cited by
- 154
- References
- 30
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 4 · 2012: 5
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Institute on Aging (R01-AG-10880, R01AG010880)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- Alzheimer's disease, apolipoprotein E, APOE ε4, insulin resistance, insulin-stimulated glucose disposal, sex differences, insulin action, energy metabolism, fasting insulin
- MeSH terms
- Aged, Alleles, Alzheimer Disease, Apolipoproteins E, Blood Glucose, Female, Genotype, Humans, Insulin, Male, Risk Factors, Sex Characteristics, Body Mass Index
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