Luchsinger José A, Reitz Christiane, Patel Bindu, Tang Ming-Xin, Manly Jennifer J, Mayeux Richard
Department of Medicine, Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10032, USA.
Arch Neurol. 2007 Apr;64(4):570-5. doi: 10.1001/archneur.64.4.570.
Type 2 diabetes mellitus is an important risk factor for Alzheimer disease and is more prevalent in elderly minority persons compared with non-Hispanic white persons.
To determine whether diabetes is related to a higher risk of mild cognitive impairment (MCI), a transitional stage between normal cognition and Alzheimer disease, in a multiethnic cohort with a high prevalence of diabetes.
Longitudinal cohort study.
Northern Manhattan in New York, NY.
We studied persons without prevalent MCI or dementia at baseline and with at least 1 follow-up interval. Of 1772 participants with a complete neuropsychological evaluation, 339 (19.1%) were excluded because of prevalent dementia, 304 were excluded because of prevalent MCI (17.2%), and 211 were excluded because of loss to follow-up (11.9%), resulting in a final sample of 918 participants for longitudinal analyses.
We related diabetes defined by self-report to incident all-cause MCI, amnestic MCI, and nonamnestic MCI. We conducted multivariate analyses with proportional hazards regression adjusting for age, sex, years of education, ethnic group, apolipoprotein E (APOE) epsilon4 allele, hypertension, low-density lipoprotein level, current smoking, heart disease, and stroke.
A total of 334 persons had incident MCI, 160 (47.9%) had amnestic MCI, and 174 (52.1%) had nonamnestic MCI. Diabetes was related to a significantly higher risk of all-cause MCI and amnestic MCI after adjustment for all covariates. Diabetes was also related to a higher risk of nonamnestic MCI, but this association was appreciably attenuated after adjustment for socioeconomic variables and vascular risk factors. The risk of MCI attributable to diabetes was 8.8% for the whole sample and was higher for African American persons (8.4%) and Hispanic persons (11.0%) compared with non-Hispanic white persons (4.6%), reflecting the higher prevalence of diabetes in minority populations in the United States.
Diabetes is related to a higher risk of amnestic MCI in a population with a high prevalence of this disorder.
2型糖尿病是阿尔茨海默病的一个重要危险因素，与非西班牙裔白人相比，在老年少数族裔中更为普遍。
在糖尿病患病率较高的多民族队列中，确定糖尿病是否与轻度认知障碍（MCI）风险较高相关，MCI是正常认知与阿尔茨海默病之间的过渡阶段。
纵向队列研究。
纽约州纽约市曼哈顿北部。
我们研究了基线时无MCI或痴呆且至少有1个随访间隔的人群。在1772名接受完整神经心理学评估的参与者中，339人（19.1%）因患痴呆被排除，304人因患MCI被排除（17.2%），211人因失访被排除（11.9%），最终有918名参与者纳入纵向分析。
我们将自我报告定义的糖尿病与全因MCI、遗忘型MCI和非遗忘型MCI的发病情况相关联。我们采用比例风险回归进行多变量分析，对年龄、性别、受教育年限、种族、载脂蛋白E（APOE）ε4等位基因、高血压、低密度脂蛋白水平、当前吸烟状况、心脏病和中风进行校正。
共有334人发生MCI，160人（47.9%）为遗忘型MCI，174人（52.1%）为非遗忘型MCI。在校正所有协变量后，糖尿病与全因MCI和遗忘型MCI风险显著升高相关。糖尿病也与非遗忘型MCI风险较高相关，但在校正社会经济变量和血管危险因素后，这种关联明显减弱。糖尿病导致的MCI风险在整个样本中为8.8%，非裔美国人（8.4%）和西班牙裔人（11.0%）高于非西班牙裔白人（4.6%），这反映了美国少数族裔人群中糖尿病患病率较高。
在这种疾病患病率较高的人群中，糖尿病与遗忘型MCI风险较高相关。
