Chang Ki Jung, Hong Chang Hyung, Lee Yunhwan, Lee Kang Soo, Roh Hyun Woong, Back Joung Hwan, Jung Young Ki, Lim Ki Young, Noh Jai Sung, Kim Hyun Chung, Choi Seong Hye, Kim Seong Yoon, Na Duk L, Seo Sang Won, Lee Soojin, Son Sang Joon
From the Department of Psychiatry, Ajou University School of Medicine (KJC, CHH, HWR, YKJ, ZKYL, JSN, SJS); Institute on Aging, Ajou University Medical Center (CHH, YL); Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon (YL); Department of Psychiatry, CHA University School of Medicine, CHA Hospital, Bundang (KSL); Health Insurance Policy Research Institute (JHB); Department of Psychiatry, National Medical Center, Seoul (HCK); Department of Neurology, Inha University College of Medicine, Incheon (SHC); Memory Impairment Center, Ajou University Hospital, Suwon (CHH); Department of Psychiatry, Asan Medical Center (SYK); Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine (DLN, SWS); and Department of Medicare Administration, Backseok Arts University, Seoul, South Korea (SL).
Medicine (Baltimore). 2015 Jun;94(23):e919. doi: 10.1097/MD.0000000000000919.
We aimed to examine risk of diabetes mellitus (DM) among older adults with Alzheimer's disease receiving 3 types of psychotropic drugs, that is, antipsychotics, antidepressants, and sedative anxiolytics. We retrospectively analyzed data from a hospital-based Clinical Research Center for Dementia of South Korea (CREDOS) study conducted between January 1, 2008 and December 31, 2012. Participants (n = 3042) with Alzheimer's disease were aged 65 or older and had no preexisting history of DM. Development of DM was identified using claims for initiating at least 1 prescription of antidiabetic medications or a diagnosis of DM during the follow-up period. Cox proportional hazards regression was used to demonstrate the Hazard ratio of DM in use of each psychotropic drug. Among the 3042 participants, 426 patients (14.0%) developed DM, representing an incidence rate of 5.2/100 person-years during an average 2.9 years of follow-up period. Among the 3 types of psychotropic drugs, antipsychotic users had a significantly higher risk of DM (hazard ratio = 1.74, 95% confidence interval = 1.10, 2.76) than nonusers, after adjusting covariates. Antidepressants and sedative anxiolytics did not achieve statistical significance. These results suggested that the diabetes risk was elevated in Alzheimer patients on antipsychotic treatment. Therefore, patients with Alzheimer's disease receiving antipsychotic treatment should be carefully monitored for the development of DM.
我们旨在研究患有阿尔茨海默病的老年人在服用3种精神药物（即抗精神病药物、抗抑郁药物和镇静抗焦虑药物）时患糖尿病（DM）的风险。我们回顾性分析了韩国一家医院的痴呆临床研究中心（CREDOS）在2008年1月1日至2012年12月31日期间进行的一项研究数据。患有阿尔茨海默病的参与者（n = 3042）年龄在65岁及以上，且既往无糖尿病病史。在随访期间，通过启动至少1种抗糖尿病药物处方的记录或糖尿病诊断来确定糖尿病的发生情况。使用Cox比例风险回归来证明每种精神药物使用中糖尿病的风险比。在3042名参与者中，426名患者（14.0%）患糖尿病，在平均2.9年的随访期内发病率为5.2/100人年。在这3种精神药物中，调整协变量后，使用抗精神病药物的患者患糖尿病的风险（风险比 = 1.74，95%置信区间 = 1.10，2.76）显著高于未使用者。抗抑郁药物和镇静抗焦虑药物未达到统计学显著性。这些结果表明，接受抗精神病药物治疗的阿尔茨海默病患者患糖尿病的风险升高。因此，接受抗精神病药物治疗的阿尔茨海默病患者应密切监测糖尿病的发生情况。
