血糖水平与痴呆风险

Glucose Levels and Risk of Dementia

血糖水平与痴呆风险

BACKGROUND

Diabetes is a risk factor for dementia. It is unknown whether higher glucose levels increase the risk of dementia in people without diabetes.

背景：糖尿病是痴呆的风险因子之一。但对于非糖尿病患者，高血糖水平是否增加痴呆风险仍然未知。

METHODS

We used 35,264 clinical measurements of glucose levels and 10,208 measurements of glycated hemoglobin levels from 2067 participants without dementia to examine the relationship between glucose levels and the risk of dementia. Participants were from the Adult Changes in Thought study and included 839 men and 1228 women whose mean age at baseline was 76 years; 232 participants had diabetes, and 1835 did not. We fit Cox regression models, stratified according to diabetes status and adjusted for age, sex, study cohort, educational level, level of exercise, blood pressure, and status with respect to coronary and cerebrovascular diseases, atrial fibrillation, smoking, and treatment for hypertension.

方法：我们对2067名非痴呆患者人群的样本进行了测定，共检测了35,264份临床血糖样本和10,208份糖化血红蛋白样本。参与者均来自Adult Changes in Thought研究，当中包括839名男性和1228名女性，平均年龄为76岁；当中232人患有糖尿病，其余1835则非糖尿病患者。我们利用Cox回归模型进行统计，并根据糖尿病状态进行分层，并综合了年龄、性别、研究队列、教育水平、运动水平、血压及其它心血管疾病等因素。

RESULTS

During a median follow-up of 6.8 years, dementia developed in 524 participants (74 with diabetes and 450 without). Among participants without diabetes, higher average glucose levels within the preceding 5 years were related to an increased risk of dementia (P=0.01); with a glucose level of 115 mg per deciliter (6.4 mmol per liter) as compared with 100 mg per deciliter (5.5 mmol per liter), the adjusted hazard ratio for dementia was 1.18 (95% confidence interval [CI], 1.04 to 1.33). Among participants with diabetes, higher average glucose levels were also related to an increased risk of dementia (P=0.002); with a glucose level of 190 mg per deciliter (10.5 mmol per liter) as compared with 160 mg per deciliter (8.9 mmol per liter), the adjusted hazard ratio was 1.40 (95% CI, 1.12 to 1.76).

结果：平均随访6.8年后，共524名参与者患上痴呆症（其中74人为糖尿病患者，其余450人则不是）。对于糖尿病患者，初始5年内的平均高血糖水平与痴呆风险增加相关；平均血糖水平115mg/分升（6.4mmol/L）与平均血糖水平100mg/分升（5.5mmol/L）相比，调整后痴呆风险比为1.18。对于患有糖尿病的参与者，高平均血糖水平同样与痴呆风险增加相关；平均血糖水平190mg/分升（10.5mmol/L）与160mg/分升（8.9mmol/L）相比，调整后的风险比为1.40。

CONCLUSIONS

Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes.

结论：该研究结果显示，高血糖水平是痴呆的危险因素之一，这种效应在非糖尿病患者群体中仍然存在。