TY - JOUR SP - 1373 SN - 1875-8908 N2 - BACKGROUND: Type 2 diabetes is associated with an increased risk for Alzheimer?s disease (AD). Regulation of normal insulin function may be important in reducing the prevalence of dementia due to AD, particularly in individuals who harbor genetic risk for or have a parental family history of AD. The relationship between insulin resistance (IR) and AD pathology remains poorly understood, particularly in midlife prior to the onset of clinical metabolic disease or cognitive decline. // OBJECTIVE: We examined associations between IR as indexed by HOMA-IR, cerebrospinal fluid (CSF) biomarkers of AD pathology, and memory in middle-aged adults enriched for AD. We postulated that higher HOMA-IR and APOE ?4 carriage would be associated with greater CSF AD pathology and poor memory performance. // METHODS: Cognitively asymptomatic middle-aged adults (N?=?70, mean age?=?57.7 years) from the Wisconsin Alzheimer?s Disease Research Center with a parental family history of dementia due to AD underwent lumbar puncture, blood draw, and neuropsychological testing. CSF AD biomarkers including soluble amyloid-? protein precursor ? (sA?PP?), amyloid-?42 (A?42), and phosphorylated tau (P-tau181) were examined with respect to HOMA-IR and APOE ?4 status. Delayed memory performance was examined with respect to HOMA-IR, CSF AD biomarkers, and APOE ?4 status. // RESULTS: Higher HOMA-IR was associated with higher sA?PP? and A?42 . APOE ?4 carriers had significantly higher levels of sA?PP?, sA?PP?, and P-tau181/A?42 compared to noncarriers. The concurrent presence of higher HOMA-IR and CSF AD pathology predicted worse delayed memory performance. // CONCLUSION: Overall, the findings suggest that IR and APOE ?4 are contributing factors to the development of AD pathology in midlife, and provide support for targeting insulin function as a potentially modifiable risk factor for AD. AV - public N1 - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions. ID - discovery10069667 UR - https://doi.org/10.3233/JAD-160110 PB - IOS PRESS JF - Journal of Alzheimer's Disease EP - 1383 A1 - Hoscheidt, SM A1 - Starks, EJ A1 - Oh, JM A1 - Zetterberg, H A1 - Blennow, K A1 - Krause, RA A1 - Gleason, CE A1 - Puglielli, L A1 - Atwood, CS A1 - Carlsson, CM A1 - Asthana, S A1 - Johnson, SC A1 - Bendlin, BB KW - APOE ?4 KW - CSF AD biomarkers KW - insulin resistance KW - memory function IS - 4 TI - Insulin Resistance is Associated with Increased Levels of Cerebrospinal Fluid Biomarkers of Alzheimer's Disease and Reduced Memory Function in At-Risk Healthy Middle-Aged Adults Y1 - 2016/// VL - 52 ER -