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他汀类药物与痴呆症患病率降低的关系:一项基于全国人口的研究。

Decreased prevalence of dementia associated with statins: a national population-based study.

作者信息

Chuang C-S, Lin C-L, Lin M-C, Sung F-C, Kao C-H

机构信息

Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.

出版信息

Eur J Neurol. 2015 Jun;22(6):912-8. doi: 10.1111/ene.12402. Epub 2014 Mar 18.

Abstract

BACKGROUND AND PURPOSE

Dementia is a neurodegenerative disorder that presents a progressive decline in cognitive function and loss of short-term memory with age. Several studies have shown that statin, an oral lipid-lowering drug, may reduce the risk of developing dementia. The objective of this study is to explore the association between statin and the development of dementia.

METHODS

The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The sample consisted of 123 300 patients ≥ 20 years of age, including 61 650 dementia patients with statin use and 61 650 patients without statin use who were eligible for inclusion in this study. Univariate and multivariate Cox proportional hazard regression analyses were performed to measure the effects of statin use on the risk of dementia.

RESULTS

The beneficial effect of statin on dementia was significant after adjusting for sociodemographic factors and comorbidities (adjusted hazard ratio of 0.92, 95% confidence interval 0.86-0.98). The sex- and age-specific analysis of adjusted hazard ratios showed a higher beneficial effect from statin treatment in women than in men, and the effect became more significant with age.

CONCLUSION

Statin therapy may help prevent the development of dementia, and both hydrophilic and lipophilic statins produce similar effects. However, the preventive characters and associated mechanisms must be further explored and identified.

摘要

背景与目的

痴呆是一种神经退行性疾病,随着年龄增长,认知功能会逐渐衰退,短期记忆丧失。多项研究表明,他汀类药物(一种口服降脂药)可能会降低患痴呆症的风险。本研究的目的是探讨他汀类药物与痴呆症发生之间的关联。

方法

本研究分析的数据取自台湾国民健康保险研究数据库。样本包括123300名年龄≥20岁的患者,其中61650名使用他汀类药物的痴呆患者以及61650名未使用他汀类药物且符合纳入本研究条件的患者。进行单因素和多因素Cox比例风险回归分析,以衡量使用他汀类药物对患痴呆症风险的影响。

结果

在调整社会人口统计学因素和合并症后,他汀类药物对痴呆症的有益作用显著(调整后的风险比为0.92,95%置信区间为0.86 - 0.98)。调整后风险比的性别和年龄特异性分析显示,他汀类药物治疗对女性的有益作用高于男性,且随着年龄增长,这种作用变得更加显著。

结论

他汀类药物治疗可能有助于预防痴呆症的发生,亲水性和脂溶性他汀类药物产生的效果相似。然而,其预防特性及相关机制仍需进一步探索和明确。

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