Steroid-induced elevation of glucose in Alzheimer's disease: relationship to gender, apolipoprotein E genotype and cognition

Glucose and insulin may play an important role in the pathophysiology and symptomatology of Alzheimer s disease (AD), and prior studies suggest interactions among glucose, insulin, gender and apolipoprotein E genotype. We analyzed the relationship between steroid-induced glucose elevation and gender, presence of the apolipoprotein E epsilon4 (APOE-4) allele and cognition using data from a multicenter trial of prednisone therapy in AD. The low-dose prednisone regimen (initial dose: 20 mg/day. maintenance dose: 10 mg/day) caused a moderate increase in random blood. glucose (mean post-baseline glucose 115 mg/dl). There was a significant interaction between rise in glucose, gender and presence of the APOE-4 allele. There was no important relationship between glucose and cognitive function at baseline or with prednisone treatment. Meta-analysis including data from three other AD trial,, showed a small influence of random blood glucose oil cognitive scores. These results support a relationship between gender, apolipoprotein F. genotype and glucose metabolism, but do not indicate that mild changes in glucose have an important impact on cognitive function. (C) 2002 Elsevier Science Ltd. All rights reserved.