Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects?

Grazia Daniela Femminella; Nicholas R Livingston; Sanara Raza; Thalia van der Doef; Eleni Frangou; Sharon Love; Gail Busza; Valeria Calsolaro; Stefan Carver; Clive Holmes; Craig W Ritchie; Robert M Lawrence; Brady McFarlane; George Tadros; Basil H Ridha; Carol Bannister; Zuzana Walker; Hilary Archer; Elizabeth Coulthard; Ben Underwood; Aparna Prasanna; Paul Koranteng; Salman Karim; Kehinde Junaid; Bernadette McGuinness; Anthony Peter Passmore; Ramin Nilforooshan; Ajayverma Macharouthu; Andrew Donaldson; Simon Thacker; Gregor Russell; Naghma Malik; Vandana Mate; Lucy Knight; Sajeev Kshemendran; Tricia Tan; Christian Holscher; John Harrison; David J Brooks; Clive Ballard; Paul Edison

doi:10.1186/s13195-021-00784-w

Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects?

Grazia Daniela Femminella
, Nicholas R Livingston
, Sanara Raza
, Thalia van der Doef
, Eleni Frangou
, Sharon Love
, Gail Busza
, Valeria Calsolaro
, Stefan Carver
, Clive Holmes
, Craig W Ritchie
, Robert M Lawrence
, Brady McFarlane
, George Tadros
, Basil H Ridha
, Carol Bannister
, Zuzana Walker
, Hilary Archer
, Elizabeth Coulthard
, Ben Underwood

Aparna Prasanna, Paul Koranteng, Salman Karim, Kehinde Junaid, Bernadette McGuinness, Anthony Peter Passmore, Ramin Nilforooshan, Ajayverma Macharouthu, Andrew Donaldson, Simon Thacker, Gregor Russell, Naghma Malik, Vandana Mate, Lucy Knight, Sajeev Kshemendran, Tricia Tan, Christian Holscher, John Harrison, David J Brooks, Clive Ballard, Paul Edison

Aston Medical School

Imperial College Trials Unit, Imperial College London; London UK
Oxford University
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.
South West London and St George's Mental Health NHS Trust
Southern Health NHS Foundation Trust
Brighton and Sussex University Hospital Trust
King's College London University of London London WC2B 4BG UK
St. Margaret's Hospital
North Bristol NHS Trust , Westbury on Trym , UK
Cambridgeshire and Peterborough NHS Foundation Trust, Peterborough, UK.
Black Country Partnership NHS Foundation Trust, West Bromwich, UK.
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK.
Lancashire Care NHS Foundation Trust, Preston, UK.
Nottinghamshire Healthcare NHS Foundation Trust
Queen's University Belfast Belfast UK,Ulster University Coleraine UK,Belfast Health & Social Care Trust Belfast UK
Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK.
NHS Ayrshire and Arran
NHS Lanarkshire
Derbyshire Healthcare NHS Foundation Trust, Derby, UK.
Bradford District Care NHS Foundation Trust, Bradford, UK.
North West Boroughs Partnership NHS Foundation Trust
CORNWALL PARTNERSHIP NHS FOUNDATION TRUST
Somerset Partnership NHS Foundation Trust, Bridgwater, UK.
South Staffordshire and Shropshire Healthcare NHS Foundation Trust
Research Department, Henan University of Chinese Medicine, Zhengzhou, China.
Alzheimer Center VUmc Amsterdam
Newcastle Business School, University of Newcastle, Australia.
University of Exeter Medical School

Research output: Contribution to journal › Article › peer-review

55 Citations (Scopus)

19 Downloads (Pure)

Abstract

BACKGROUND: Type 2 diabetes is a risk factor for Alzheimer's disease (AD), and AD brain shows impaired insulin signalling. The role of peripheral insulin resistance on AD aetiopathogenesis in non-diabetic patients is still debated. Here we evaluated the influence of insulin resistance on brain glucose metabolism, grey matter volume and white matter lesions (WMLs) in non-diabetic AD subjects.

METHODS: In total, 130 non-diabetic AD subjects underwent MRI and [18F]FDG PET scans with arterial cannula insertion for radioactivity measurement. T1 Volumetric and FLAIR sequences were acquired on a 3-T MRI scanner. These subjects also had measurement of glucose and insulin levels after a 4-h fast on the same day of the scan. Insulin resistance was calculated by the updated homeostatic model assessment (HOMA2). For [18F]FDG analysis, cerebral glucose metabolic rate (rCMRGlc) parametric images were generated using spectral analysis with arterial plasma input function.

RESULTS: In this non-diabetic AD population, HOMA2 was negatively associated with hippocampal rCMRGlc, along with total grey matter volumes. No significant correlation was observed between HOMA2, hippocampal volume and WMLs.

CONCLUSIONS: In non-diabetic AD, peripheral insulin resistance is independently associated with reduced hippocampal glucose metabolism and with lower grey matter volume, suggesting that peripheral insulin resistance might influence AD pathology by its action on cerebral glucose metabolism and on neurodegeneration.

Original language	English
Article number	47
Journal	Alzheimer's research & therapy
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/s13195-021-00784-w
Publication status	Published - 17 Feb 2021

Bibliographical note

© The Author(s). 2021 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Funding Information:
This study was funded by Alzheimer’s Drug Discovery Foundation, US, Alzheimer’s Society, UK, Novo Nordisk A/S, Van Geest Foundation, NIHR Biomedical Research Centre, Imperial College London and Kings College London. Dr. Edison was funded by the Medical Research Council and now by the Higher Education Funding Council for England (HEFCE). He has also received grants from Alzheimer’s Research, UK, Alzheimer’s Drug Discovery Foundation, Alzheimer’s Society, UK, Novo Nordisk, GE Healthcare, Astra Zeneca, Pfizer, Eli Lilly and Piramal Life Sciences.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Alzheimer Disease
Insulin Resistance
Magnetic Resonance Imaging
Positron-Emission Tomography Imaging

Access to Document

10.1186/s13195-021-00784-wLicence: CC BY 4.0

s13195_021_00784_w
© The Author(s). 2021 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Final published version, 628 KBLicence: CC BY 4.0

Cite this

Femminella, G. D., Livingston, N. R., Raza, S., van der Doef, T., Frangou, E., Love, S., Busza, G., Calsolaro, V., Carver, S., Holmes, C., Ritchie, C. W., Lawrence, R. M., McFarlane, B., Tadros, G., Ridha, B. H., Bannister, C., Walker, Z., Archer, H., Coulthard, E., ... Edison, P. (2021). Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects? Alzheimer's research & therapy, 13(1), Article 47. https://doi.org/10.1186/s13195-021-00784-w

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title = "Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects?",

abstract = "BACKGROUND: Type 2 diabetes is a risk factor for Alzheimer's disease (AD), and AD brain shows impaired insulin signalling. The role of peripheral insulin resistance on AD aetiopathogenesis in non-diabetic patients is still debated. Here we evaluated the influence of insulin resistance on brain glucose metabolism, grey matter volume and white matter lesions (WMLs) in non-diabetic AD subjects.METHODS: In total, 130 non-diabetic AD subjects underwent MRI and [18F]FDG PET scans with arterial cannula insertion for radioactivity measurement. T1 Volumetric and FLAIR sequences were acquired on a 3-T MRI scanner. These subjects also had measurement of glucose and insulin levels after a 4-h fast on the same day of the scan. Insulin resistance was calculated by the updated homeostatic model assessment (HOMA2). For [18F]FDG analysis, cerebral glucose metabolic rate (rCMRGlc) parametric images were generated using spectral analysis with arterial plasma input function.RESULTS: In this non-diabetic AD population, HOMA2 was negatively associated with hippocampal rCMRGlc, along with total grey matter volumes. No significant correlation was observed between HOMA2, hippocampal volume and WMLs.CONCLUSIONS: In non-diabetic AD, peripheral insulin resistance is independently associated with reduced hippocampal glucose metabolism and with lower grey matter volume, suggesting that peripheral insulin resistance might influence AD pathology by its action on cerebral glucose metabolism and on neurodegeneration.",

keywords = "Alzheimer Disease, Insulin Resistance, Magnetic Resonance Imaging, Positron-Emission Tomography Imaging",

author = "Femminella, \{Grazia Daniela\} and Livingston, \{Nicholas R\} and Sanara Raza and \{van der Doef\}, Thalia and Eleni Frangou and Sharon Love and Gail Busza and Valeria Calsolaro and Stefan Carver and Clive Holmes and Ritchie, \{Craig W\} and Lawrence, \{Robert M\} and Brady McFarlane and George Tadros and Ridha, \{Basil H\} and Carol Bannister and Zuzana Walker and Hilary Archer and Elizabeth Coulthard and Ben Underwood and Aparna Prasanna and Paul Koranteng and Salman Karim and Kehinde Junaid and Bernadette McGuinness and Passmore, \{Anthony Peter\} and Ramin Nilforooshan and Ajayverma Macharouthu and Andrew Donaldson and Simon Thacker and Gregor Russell and Naghma Malik and Vandana Mate and Lucy Knight and Sajeev Kshemendran and Tricia Tan and Christian Holscher and John Harrison and Brooks, \{David J\} and Clive Ballard and Paul Edison",

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doi = "10.1186/s13195-021-00784-w",

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Femminella, GD, Livingston, NR, Raza, S, van der Doef, T, Frangou, E, Love, S, Busza, G, Calsolaro, V, Carver, S, Holmes, C, Ritchie, CW, Lawrence, RM, McFarlane, B, Tadros, G, Ridha, BH, Bannister, C, Walker, Z, Archer, H, Coulthard, E, Underwood, B, Prasanna, A, Koranteng, P, Karim, S, Junaid, K, McGuinness, B, Passmore, AP, Nilforooshan, R, Macharouthu, A, Donaldson, A, Thacker, S, Russell, G, Malik, N, Mate, V, Knight, L, Kshemendran, S, Tan, T, Holscher, C, Harrison, J, Brooks, DJ, Ballard, C & Edison, P 2021, 'Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects?', Alzheimer's research & therapy, vol. 13, no. 1, 47. https://doi.org/10.1186/s13195-021-00784-w