Resumo
INTRODUÇÃO A Doença de Alzheimer (DA) caracteriza-se por perda cognitiva progressiva aliado ao prejuízo funcional associado à idade. As suas duas grandes marcas são as placas β-amilóides e os emaranhados neurofibrilares. Existem fortes evidências de relação entre Síndrome Metabólica (SM) e DA. As duas patologias são bastante prevalentes e dependentes do envelhecimento. OBJETIVOS O presente estudo busca compreender o papel da síndrome metabólica na fisiopatologia da doença de Alzheimer e descrever intervenções preventivas e terapêuticas. METODOLOGIA A revisão foi feita a partir da busca artigos científicos nas bases eletrônicas PUBMED e Web of Science, empregando os descritores "Doença de Alzheimer”, “Síndrome Metabólica” DISCUSSÃO A SM é um desarranjo metabólico com potencial de danificar a sinalização insulínica no cérebro, provocando resistência à insulina, inibindo o clearance β-amilóide e sua acumulação, o que gera neuroinflamação. Além disso, induz estado pró-trombótico com efeitos isquêmicos, resultando em estresse oxidativo e neuroinflamação e atrofias encefálicas locais progressivas. Os componentes da SM relacionam-se com a DA exacerbando a neuroinflamação e resistência à insulina. Medidas preventivas e terapêuticas visando a SM são promissoras. CONSIDERAÇÕES FINAIS A partir das análises elaboradas neste presente estudo, percebe-se diferentes relações entre os componentes da SM e a DA, sendo os primeiros possíveis causas e/ou efeitos da segunda. Posto que a resistência à insulina desempenha papel principal na iniciação e perpetuação de danos cognitivos na DA. Ademais, os componentes da SM associada à DA, quando tratados com medidas preventivas e terapêuticas quebram essa associação ao promover reequilíbrio do metabolismo.
Referências
2. Ali, Abuzer, et al. (2020), "Deciphering the Role of Wnt Signaling in Metabolic Syndrome-Linked Alzheimer's Disease", Molecular Neurobiology 57.1 : 302-14.
3. Armstrong, Richard A. (2019), "Risk Factors for Alzheimer's Disease", Folia Neuropathologica 57.2 : 87-105.
4. Atti, Anna Rita, et al. (2019), "Metabolic Syndrome, Mild Cognitive Impairment, and Dementia: A Meta-Analysis of Longitudinal Studies", American Journal of Geriatric Psychiatry 27.6 : 625-37.
5. Breijyeh, Zeinab; Karaman, Rafik (2020), "Comprehensive Review on Alzheimer's Disease: Causes and Treatment", Molecules 25,24.
6. Campos-Pena, Victoria, et al. (2017), "Metabolic Syndrome as a Risk Factor for Alzheimer's Disease: Is a Beta a Crucial Factor in Both Pathologies?", Antioxidants & Redox Signaling 26,10 : 542-+.
7. Cooper, Claudia, et al. (2015), "Modifiable Predictors of Dementia in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis" ,American Journal of Psychiatry 172.4: 323-34.
8. Crous-Bou, Marta, et al. (2017), "Alzheimer's Disease Prevention: From Risk Factors to Early Intervention", Alzheimers Research & Therapy 9.
9. De la Monte, Suzanne M. (2017), "Insulin Resistance and Neurodegeneration: Progress Towards the Development of New Therapeutics for Alzheimer's Disease", Drugs 77.1: 47-65.
10. Exalto, Lieza G., et al. (2015), "The Metabolic Syndrome in a Memory Clinic Population: Relation with Clinical Profile and Prognosis", Journal of the Neurological Sciences 351.1-2: 18-23.
11. Gomez, Gabriela, et al. (2018), "Metabolic Syndrome and Amyloid Accumulation in the Aging Brain", Journal of Alzheimers Disease 65.2: 629-39.
12. Hane, Francis T, et al. (2017), "Recent Progress in Alzheimer's Disease Research, Part 3: Diagnosis and Treatment", Journal of Alzheimers Disease 57.3: 645-65.
13. Hishikawa, N, et al. (2016), "Cognitive and Affective Functions in Alzheimer's Disease Patients with Metabolic Syndrome", European Journal of Neurology 23.2: 339-45.
14. Hooshmand, Babak, et al. (2019), "Serum Insulin and Cognitive Performance in Older Adults: A Longitudinal Study", American Journal of Medicine 132.3: 367-73.
15. Iadecola, Costantino; Gottesman, Rebeca F. (2019), "Neurovascular and Cognitive Dysfunction in Hypertension Epidemiology, Pathobiology, and Treatment." Circulation Research 124.7: 1025-44.
16. Kotkowski, Eithan, et al. (2019), "A Neural Signature of Metabolic Syndrome", Human Brain Mapping 40,12: 3575-88.
17. Kuan, Yi-Chun, et al. (2017), "Effects of Metformin Exposure on Neurodegenerative Diseases in Elderly Patients with Type 2 Diabetes Mellitus", Progress in Neuro-Psychopharmacology & Biological Psychiatry, 79: 77-83.
18. Lee, Jung Hyun, et al. (2018), "Targeting Insulin for Alzheimer's Disease: Mechanisms, Status and Potential Directions", Journal of Alzheimers Disease, 64: S427-S53.
19. Lee, Seung-Hwan, et al. (2016), "Insulin in the Nervous System and the Mind: Functions in Metabolism, Memory, and Mood", Molecular Metabolism, 5.8: 589-601.
20. Luque-Contreras, Diana, et al. (2014), "Oxidative Stress and Metabolic Syndrome: Cause or Consequence of Alzheimer's Disease?", Oxidative Medicine and Cellular Longevity 2014.
21. Mcgrattan, Andrea M., et al. (2019), "Diet and Inflammation in Cognitive Ageing and Alzheimer’s Disease", Current Nutrition Reports 8.2: 53-65.
22. Nasoohi, Sanaz, et al. (2018), "Metabolic Syndrome, Brain Insulin Resistance, and Alzheimer's Disease: Thioredoxin Interacting Protein (Txnip) and Inflammasome as Core Amplifiers", Journal of Alzheimers Disease, 66.3 (2018): 857-85.
23. Rios, Juvenal A, et al. (2014), "Is Alzheimer's Disease Related to Metabolic Syndrome? A Wnt Signaling Conundrum", Progress in Neurobiology, 121: 125-46.
24. Rojas-Gutierrez, Eduardo, et al. (2017), "Alzheimer's Disease and Metabolic Syndrome: A Link from Oxidative Stress and Inflammation to Neurodegeneration", Synapse 71.10.
25. Sanchez-Sarasua, Sandra, et al. (2020), "Can We Treat Neuroinflammation in Alzheimer's Disease?", International Journal of Molecular Sciences, 21,22.
26. Silva, Marcos Vinícius Ferreira, et al. (2019), "Alzheimer's Disease: Risk Factors and Potentially Protective Measures", Journal of Biomedical Science, 26.
27. Walker, Jennifer M.; Harrison, Fiona E. (2015), "Shared Neuropathological Characteristics of Obesity, Type 2 Diabetes and Alzheimer's Disease: Impacts on Cognitive Decline", Nutrients 7.9: 7332-57.
28. Wang, Helen H., et al. (2020), "Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome", Pediatric Gastroenterology Hepatology & Nutrition, 23.3: 189-230.
29. Weller, Jason; Budson, Andrew (2018), "Current Understanding of Alzheimer’s Disease Diagnosis and Treatment", F1000Research 7: 1161.