Peila Rita, Rodriguez Beatriz L, White Lon R, Launer Lenore J
Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Room 3C-309 Gateway Building, 7201 Wisconsin Avenue, Bethesda, MD 20892, USA.
Neurology. 2004 Jul 27;63(2):228-33. doi: 10.1212/01.wnl.0000129989.28404.9b.
To evaluate the association of fasting insulin level to incident dementia in a cohort of elderly men.
Data are from the Honolulu-Asia Aging Study, a community-based study of Japanese-American men, aged 71 to 91 years in 1991. Serum insulin was measured in 1991 and participants were grouped based on their insulin levels. Dementia was ascertained in 1991, 1994, and 1996 according to international guidelines. The 2,568 men dementia-free in 1991 were reexamined in 1994 and 1996; 244 new cases of dementia were diagnosed. Survival analysis with age as the time scale was used to estimate the risk (hazard ratio [HR] and 95% CI) for incident dementia associated with levels of insulin.
The risk of dementia was increased at the two extremes of the insulin distribution (lower and upper 15th percentiles). Compared to the rest of the cohort subjects in the lowest 15th percentile and highest 15th percentile had an increased risk for dementia (HR = 1.54, CI 1.11 to 2.11 and HR = 1.54, CI 1.05 to 2.26). In men with insulin levels <22.2 mIU/L the risk for dementia decreased with increased levels of insulin (HR = 0.76, CI 0.72 to 0.79 for each increase of one logarithmic unit -2.72 mIU/L of insulin). In men with insulin levels >/=22.2 mIU/L the risk for dementia increased with increasing levels of insulin (HR = 1.64, CI = 1.07 to 2.52 for each 2.72 mIU/L).
Both low and high levels of insulin are associated with an increased risk of developing dementia.
评估老年男性队列中空腹胰岛素水平与新发痴呆症之间的关联。
数据来自檀香山-亚洲老年研究，这是一项基于社区的对1991年年龄在71至91岁的日裔美国男性的研究。1991年测量了血清胰岛素，并根据胰岛素水平对参与者进行分组。根据国际指南在1991年、1994年和1996年确定痴呆症情况。1991年无痴呆症的2568名男性在1994年和1996年接受了复查；诊断出244例新发痴呆症病例。以年龄为时间尺度进行生存分析，以估计与胰岛素水平相关的新发痴呆症风险（风险比[HR]和95%置信区间）。
在胰岛素分布的两个极端（最低和最高第15百分位数），痴呆症风险增加。与队列中其余处于最低第15百分位数的受试者相比，最高第15百分位数的受试者患痴呆症的风险增加（HR = 1.54，置信区间1.11至2.11；HR = 1.54，置信区间1.05至2.26）。在胰岛素水平<22.2 mIU/L的男性中，痴呆症风险随胰岛素水平升高而降低（胰岛素每增加一个对数单位-2.72 mIU/L，HR = 0.76，置信区间0.72至0.79）。在胰岛素水平≥2至2 mIU/L的男性中，痴呆症风险随胰岛素水平升高而增加（每2.72 mIU/L，HR = 1.64，置信区间 = 1.07至2.52）。
胰岛素水平过低和过高均与患痴呆症风险增加相关。
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