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9 胰島素樣生長因子-I改善血腦屏障改變
已有大量研究證明血腦屏障的改變是糖尿病認(rèn)知功能障礙的發(fā)病機(jī)制之一。糖尿病患者腦微血管病變普遍存在，而血腦屏障（BBB)是腦微血管獨特的生理功能，其從結(jié)構(gòu)到功能發(fā)生了一系列的改變，其中包括轉(zhuǎn)運功能的改變——葡萄糖BBB轉(zhuǎn)運減少（這可能是CNS對長期高血糖毒性作用的一種適應(yīng))。其機(jī)制是葡萄糖轉(zhuǎn)運子（GLU-I)的表達(dá)減少，從而引起腦組織對葡萄糖的攝入減低，導(dǎo)致認(rèn)知功能障礙［25］。而近來有研究證明IGF-I可以提高GLU-I轉(zhuǎn)運葡萄糖的能力。因此IGF-I可以通過改善BBB葡萄糖的轉(zhuǎn)運來改善認(rèn)知功能。
綜上所述，IGF-I與糖尿病認(rèn)知功能障礙之間存在著密切的聯(lián)系，IGF-I可從很多機(jī)制上改善糖尿病認(rèn)知功能障礙。但糖尿病認(rèn)知功能障礙的發(fā)病機(jī)制十分復(fù)雜，IGF-I參與糖尿病認(rèn)知功能障礙的機(jī)制還不十分明確，在這方面我們尚有大量工作要做。且目前尚無IGF-I用于改善糖尿病認(rèn)知功能障礙的臨床實驗研究。期待有一天IGF-I可以在臨床上應(yīng)用來改善糖尿病患者的認(rèn)知功能，為提高其生活質(zhì)量作出貢獻(xiàn)。
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