Diabetology-Nutrition Unit, University Hospital of Bordeaux, Pessac, France.
Diabetes Care. 2009 Jan;32(1):169-74. doi: 10.2337/dc08-0272. Epub 2008 Oct 22.
Associations between metabolic syndrome and its individual components with risk of incident dementia and its different subtypes are inconsistent.
The 7,087 community-dwelling subjects aged > or =65 years were recruited from the French Three-City (3C) cohort. Hazard ratios (over 4 years) of incident dementia and its subtypes (vascular dementia and Alzheimer's disease) and association with metabolic syndrome (defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria) and its individual components (hypertension, large waist circumference, high triglycerides, low HDL cholesterol, and elevated fasting glycemia) were estimated in separate Cox proportional hazard models.
Metabolic syndrome was present in 15.8% of the study participants. The presence of metabolic syndrome increased the risk of incident vascular dementia but not Alzheimer's disease over 4 years, independent of sociodemographic characteristics and the apolipoprotein (apo) Eepsilon4 allele. High triglyceride level was the only component of metabolic syndrome that was significantly associated with the incidence of all-cause (hazard ratio 1.45 [95% CI 1.05-2.00]; P = 0.02) and vascular (2.27 [1.16-4.42]; P = 0.02) dementia, even after adjustment of the apoE genotype. Diabetes, but not impaired fasting glycemia, was significantly associated with all-cause (1.58 [1.05-2.38]; P = 0.03) and vascular (2.53 [1.15-5.66]; P = 0.03) dementia.
The observed relation between high triglycerides, diabetes, and vascular dementia emphasizes the need for detection and treatment of vascular risk factors in older individuals in order to prevent the likelihood of clinical dementia.
代谢综合征及其各组分与痴呆症发病风险及其不同亚型之间的关联并不一致。
本研究共纳入了来自法国 3 个城市（3C）队列的 7087 名年龄>65 岁的社区居民。使用 Cox 比例风险模型，分别估计了代谢综合征（根据美国国家胆固醇教育计划成人治疗专家组 III 标准定义）及其各组分（高血压、大腰围、高甘油三酯、低 HDL 胆固醇和空腹高血糖）与 4 年内新发痴呆症及其亚型（血管性痴呆和阿尔茨海默病）之间的风险比。
研究参与者中存在代谢综合征的比例为 15.8%。在调整了社会人口学特征和载脂蛋白（apo）Eepsilon4 等位基因后，4 年内存在代谢综合征可显著增加新发血管性痴呆的风险，但对阿尔茨海默病无显著影响。高甘油三酯水平是代谢综合征中唯一一个与全因（风险比 1.45[95%可信区间 1.05-2.00]；P=0.02）和血管性（2.27[1.16-4.42]；P=0.02）痴呆显著相关的组分，即使调整了 apoE 基因型也是如此。糖尿病，但不是空腹血糖受损，与全因（1.58[1.05-2.38]；P=0.03）和血管性（2.53[1.15-5.66]；P=0.03）痴呆显著相关。
高甘油三酯、糖尿病与血管性痴呆之间的这种观察到的关系强调了在老年人中检测和治疗血管危险因素的必要性，以降低发生临床痴呆的可能性。
