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The association of insulin resistance and dementia was observed by several authors. The activity of paraoxonase1 (PON1), the enzyme playing a protective role against oxidative stress, was decreased in demented patients. The aim of this study was to investigate relationship of PON1 Q192R polymorphism and insulin resistance. From demented patients (59 with probable AD, 24 with VaD and 38 with MD) and 51 controls DNA was isolated and Q and R isoforms were identified basing on Humbert et al.method (1993) with minor modifications. In the same subjects the following determinations were performed: serum fasting glucose, glucose 2 hours after 75g glucose load and fasting insulin using DRG ELISA kits. HOMA-IR index was calculated.. In the patients with dementia 47.9% of QQ , 43% of QR and 9.1% of RR genotypes were identified and in the controls respectively 54.9, 35.3 and 9.9 ones . Statistically significant associations of the R allele carriers with insulin level and with HOMA-IR index were stated. Borderline significant association with glucose after glucose load level (impaired glucose tolerance-IGT) were observed. The results show the asssociation of Q192R PON1 polymorphism with insulin resistance. However due to the small sample size the results should be considered as preliminary.
In serum of 114 patients with dementia and of 102 controls the titer of G class immunoglobulins directed against oxidized low density lipoproteins (LDL) was determined by ELISA method using OLAB kits. In isolated DNA apolipoprotein E (APOE) gene polymorphism was identifi ed. In the group with dementia a tendency to lower antibodies levels in e4 allele carriers and to higher ones in the e2 group was observed. In some individuals very high levels of the antibodies were stated exceeding the 90 percentile of the investigated groups. The prevalence of very high anti-ox LDL antibodies level was signifi cantly more frequent in the carriers of e2 allele and less frequent in the carriers of e4 allele. These results could suggest a role of apolipoprotein E polymorphism in the immune response against oxidized low density lipoproteins. This could play an additional role in the pathogenesis of dementia.
In a group of 194 persons aged 54–86 years global DNA methylation was determined using Imprint DNA Quantification KitMDQ1 (Sigma-Aldrich). The association with several biochemical factors as serum glucose,serum creatinine and folic acid (determined by chemiluminescence) levels as well as with sex, age and cognitive status was estimated by multivariate stepwise regression analysis. The strongest association was stated with serum creatinine (P=0.0003), with serum folic acid (P=0.005) and with glucose (0.008) levels. The mechanisms and significance of these associations is discussed in view of human aging and age-connected diseases as atherosclerosis, diabetes and renal failure
Several authors observed a diminished insulin sensitivity in dementia. It was proposed that dementia could be treated as a kind of diabetes type 2 expressed mainly in the brain. In insulin resistance states insulin levels in blood serum are usually elevated. In this work a group of 140 demented patients was investigated: 63 of them were diagnosed as probable Alzheimer disease (AD), 33 as dementia of vascular origin (VaD) and 44 as mixed dementia (MD) and compared with 59 individuals without dementia. Dementia was diagnosed according to DSM-IV and the kind of dementia by NINCDS-ADRDA criteria. Fasting glucose and glucose after glucose load level was determined by enzymatic method. Fasting insulin concentration was assayed using ELISA using DRG kits. Homeostasis Model Assessment (HOMA-IR) - the most frequently used index of insulin resistance was calculated. Statistically significant higher glucose levels after glucose load (impaired glucose tolerance IGT) were stated in the group of dementia as compared with controls. Elevated HOMA-IR values were more frequently observed in patients with dementia as compared with controls borderline significantly in the VaD and MD groups. The results indicate abnormal glucose metabolism expressed as IGT as well as probable glucose resistance in dementia.
Autosomal dominant hypercholesterolemia (ADH) is caused by mutations in the genes coding for the low-density lipoprotein receptor (LDLR), apolipoprotein B-100 (APOB), or proprotein convertase subtilisin/kexin type 9 (PCSK9). In this study, a molecular analysis of LDLR and APOB was performed in a group of 378 unrelated ADH patients, to explore the mutation spectrum that causes hypercholesterolemia in Poland. All patients were clinically diagnosed with ADH according to a uniform protocol and internationally accepted WHO criteria. Mutational analysis included all exons, exon-intron boundaries and the promoter sequence of the LDLR, and a fragment of exon 26 of APOB. Additionally, the MLPA technique was applied to detect rearrangements within LDLR. In total, 100 sequence variations were identified in 234 (62%) patients. Within LDLR, 40 novel and 59 previously described sequence variations were detected. Of the 99 LDLR sequence variations, 71 may be pathogenic mutations. The most frequent LDLR alteration was a point mutation p.G592E detected in 38 (10%) patients, followed by duplication of exons 4-8 found in 16 individuals (4.2%). Twenty-five cases (6.6%) demonstrated the p.R3527Q mutation of APOB. Our findings imply that major rearrangements of the LDLR gene as well as 2 point mutations (p.G592E in LDLR and p.R3527Q in APOB) are frequent causes of ADH in Poland. However, the heterogeneity of LDLR mutations detected in the studied group confirms the requirement for complex molecular studies of Polish ADH patients.
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