Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Neuroepidemiology. 2014;42(4):252-9. doi: 10.1159/000362201. Epub 2014 Jun 7.
There is evidence of a synergistic interaction between obesity and sedentary lifestyle with respect to diabetes. Although diabetes is a known risk factor for dementia, it is unclear if both diseases have common aetiologies.
A community-based sample of 1,448 Swedish women, aged 38-60 years and free of diabetes and dementia in 1968, was followed by means of up to 5 examinations spread over 34 years. 9.6% of all women developed diabetes and 11.4% developed dementia (over 40,000 person-years of follow-up for each disease). Cox proportional hazard regression was used to assess the influence of selected risk factors on both diseases, and the relation between diabetes and dementia.
Comparing risk factors for incident diabetes and dementia, both diseases showed a synergistic association with obesity combined with a low level of leisure time physical activity [hazard ratio (HR) for interaction = 2.7, 95% confidence interval (CI) = 1.2-6.3 for diabetes and HR = 3.3, 95% CI = 1.1-9.9 for dementia]. Development of diabetes doubled the risk for subsequent dementia (HR = 2.2, 95% CI = 1.1-4.4), which was slightly reduced upon adjustment for common risk factors.
Shared risk factors suggest a similar aetiology for diabetes and dementia and partially explain the association between diseases.
肥胖和久坐的生活方式与糖尿病之间存在协同作用的证据。尽管糖尿病是痴呆的已知危险因素，但不清楚这两种疾病是否具有共同的病因。
本研究对 1968 年时年龄在 38-60 岁且无糖尿病和痴呆的 1448 名瑞典女性进行了一项基于社区的研究，随访时间长达 34 年，共进行了 5 次检查。随访期间，9.6%的女性发生了糖尿病，11.4%发生了痴呆（每种疾病的随访时间超过 40000 人年）。使用 Cox 比例风险回归来评估选定的危险因素对两种疾病的影响，以及糖尿病与痴呆之间的关系。
比较糖尿病和痴呆的发病风险因素，发现这两种疾病与肥胖合并低水平的休闲时间体力活动呈协同关联[交互作用的危险比（HR）为 2.7，95%置信区间（CI）为 1.2-6.3 用于糖尿病，HR = 3.3，95%CI = 1.1-9.9 用于痴呆]。糖尿病的发生使随后发生痴呆的风险增加了一倍（HR = 2.2，95%CI = 1.1-4.4），但在调整常见危险因素后，这种关联略有减弱。
共同的风险因素表明糖尿病和痴呆具有相似的病因，并部分解释了这两种疾病之间的关联。
