Clinical Study On Relationship Among Insulin Sensitivity,Insulin-like Growth Factor Binding Protein-1 And Traditional Chinese Medicine Syndrome Of Senile Dementia

Objective:To investigate the relationship and significance among insulin sensitivity (ISI),insulin-like growth factor binding protein-1(IGFBP-1) and traditional chinese medicine syndrome of senile dementia.Methods:Observation group and Control group,which collect patients in the wards and out-patient clinic of geriatrics division in Nanjing Durm Tower Hospital from November 2008 to July 2009. Observation group includes senile dementia patients,which is grouped by the diagnostic standard of Traditional Chinese Medicine:deficiency of spleen-kidney group,obstruction by phlegm-blood stasis and deficiency of Qi group. Control group includes patients without dementia.The fasting serum insulin (FINS) and IGFBP-1 are detected by radioimmunity and ELISA.The insulin resistance index(IAI) is calculated.We compare fasting blood glucose (FBG),FINS,IGFBP-1,IAI,blood lipid,blood pressure and MMSE among each group.Results:1,there is no difference of the level of fasting blood glucose among deficiency of spleen-kidney group,obstruction by phlegm-blood stasis and deficiency of Qi group and control group(P> 0.05).2,the level of serum insulin in deficiency of spleen-kidney group obstruction by phlegm-blood stasis and deficiency of Qi group are increased compared with control group,which have significant differences (P< 0.01);INS in deficiency of spleen-kidney group is higher than in obstruction by phlegm-blood stasis and deficiency of Qi group,and there is significant difference between two traditional chinese medicine syndrome types (P< 0.01).3,compared with control group, the level of insulin resisrance index in deficiency of spleen-kidney group,obstruction by phlegm-blood stasis and deficiency of Qi group are decreased,which have differences(P< 0.01, P< 0.05);IAI in deficiency of spleen-kidney group is lower than in obstruction by phlegm-blood stasis and deficiency of Qi group,and there is difference between two types (P< 0.05).4,IGFBP-1 in deficiency of spleen-kidney group,obstruction by phlegm-blood stasis and deficiency of Qi group are higher than in control group,which have significant differences (P< 0.01); IGFBP-1 in deficiency of spleen-kidney group is higher than in obstruction by phlegm-blood stasis and deficiency of Qi group,and there is difference between two traditional chinese medicine syndrome types(P< 0.05).5,Pearson correlation analysis show that IGFBP-1 is correlated with FBG,FINS and IAI.Among them,IGFBP-1 is positively correlated with FBG and FINS,and negatively correlated with IAI.6,Triglyceride in deficiency of spleen-kidney group is higher than in control group,which has difference(P< 0.05);other blood lipid has no difference among each group (P> 0.05).7,Systolic pressure in two TCM type are higher than in control group,there are differences (P< 0.01, P<0.05);Systolic pressure in deficiency of spleen-kidney group is highest in three groups,and there is difference between two types(P< 0.05); Diastolic pressure in deficiency of spleen-kidney group is higher than in control group,which has difference (P< 0.05).8,there is no difference of MMSE in deficiency of spleen-kidney group,obstruction by phlegm-blood stasis and deficiency of Qi group(P> 0.05).9,there is no difference of FBG,FINS,IAI,IGFBP-1,MMSE,TG,HDL-C,LDL-C and blood pressure in different age(P> 0.05), there is difference of T-ch in different age (P< 0.05)Conclusion:Senile dementia is correlated with ISI,IGFBP-1. Senile dementia which caused by deficiency of spleen-kidney has more relationshiop with the metabolism of INS.