Luís Jesuíno de Oliveira Andrade, Gabriela Matos, Luís Matos de Oliveira
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引用次数: 0
Abstract
Alzheimer disease (AD) is a neurodegenerative disorder. Evidence suggests that AD shares pathophysiological similarities with type 2 diabetes. Intranasal insulin (INI) has emerged as a potential therapeutic approach for AD by directly targeting the brain and modulating insulin signaling pathways.
Objective: To evaluate the efficacy and safety of INI therapy for AD through a systematic review and meta-analysis of randomized controlled trials.
Methods: A search of electronic databases, including PubMed, Web of Science, Scopus, and Embase, was conducted to identify relevant studies published up to June 2024. Inclusion criteria encompassed peer-reviewed original research articles focused on humans, investigating the therapeutic effects of INI administration on cognitive impairment associated with AD, and reporting quantitative data on cognitive outcomes, biomarkers, or pathological markers relevant to AD. A meta-analysis was conducted to quantitatively synthesize the effects of INI on cognitive outcomes.
Results: A total of 647 articles were identified, and eight studies met the inclusion criteria. The overall odds ratio was 3.75 (95%CI 1.49-9.40). The test for overall effect showed a statistically significant difference (p<0.05). However, the I2 value indicated a high level of heterogeneity (85.5%), suggesting significant variability among the studies.
Conclusion: While the current data is not yet conclusive enough to definitively establish INI as a standard treatment for AD, the evidence supporting its safety, efficacy, and reduced risk of systemic side effects suggests potential cognitive benefits for improving global cognition in patients with AD.
阿尔茨海默病（AD）是一种神经退行性疾病。有证据表明，AD与2型糖尿病在病理生理上有相似之处。鼻内胰岛素（INI）通过直接靶向大脑和调节胰岛素信号通路而成为一种潜在的治疗AD的方法。目的：通过对随机对照试验的系统评价和荟萃分析，评价INI治疗AD的疗效和安全性。方法：检索PubMed、Web of Science、Scopus、Embase等电子数据库，检索截止到2024年6月发表的相关研究。纳入标准包括以人类为研究对象的同行评审的原创研究文章，研究INI给药对AD相关认知障碍的治疗效果，并报告与AD相关的认知结果、生物标志物或病理标志物的定量数据。进行了一项荟萃分析，以定量综合INI对认知结果的影响。结果：共纳入647篇文献，其中8篇符合纳入标准。总优势比为3.75 （95%CI 1.49-9.40）。总体效果检验显示差异有统计学意义(p2值表明异质性较高（85.5%），表明研究间存在显著差异。结论：虽然目前的数据还不足以确定INI作为AD的标准治疗方法，但支持其安全性、有效性和降低全身副作用风险的证据表明，在改善AD患者的整体认知方面有潜在的认知益处。
期刊介绍：
Dementia top Neuropsychologia the official scientific journal of the Cognitive Neurology and Ageing Department of the Brazilian Academy of Neurology and of the Brazilian Association of Geriatric Neuropsychiatry, is published by the "Associação Neurologia Cognitiva e do Comportamento", a nonprofit Brazilian association. Regularly published on March, June, September, and December since 2007.
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