Rosness Tor Atle, Engedal Knut, Bjertness Espen, Strand Bjørn Heine
Institute of Health and Society, University of Oslo, Oslo, Norway.
Norwegian Advisory Unit for Aging and Health, Vestfold Health Trust, Toensberg, Norway.
J Am Geriatr Soc. 2016 Jan;64(1):156-61. doi: 10.1111/jgs.13870.
To investigate the association between random measured glucose levels in middle and old age and dementia-related death.
Population-based cohort study.
Norwegian Counties Study (middle-aged individuals; 35-49) and Cohort of Norway participants (older individuals; 65-80).
Individuals without (n=74,630) and with (n=3,095) known diabetes mellitus (N=77,725); 67,865 without and 2,341 with diabetes mellitus were included in the complete case analyses (nonmissing for all included covariates), of whom 1,580 without and 131 with diabetes mellitus died from dementia-related causes.
Dementia-related death was ascertained according to the Norwegian Cause of Death Registry. Cox regression was used to assess the relationship between random glucose levels (nonfasting) in individuals without and with diabetes mellitus and dementia-related death. Education, smoking, cardiovascular disease, body mass index, cholesterol, blood pressure, and physical activity were adjusted for.
Individuals without diabetes mellitus at midlife with glucose levels between 6.5 and 11.0 mmol/L had a significantly greater risk of dementia-related death than those with levels less than 5.1 mmol/L (hazard ratio=1.32, 95% confidence interval=1.04-1.67) in a fully adjusted model. A dose-response relationship (P=.02) was observed. No significant association between high glucose levels in individuals aged 65 to 80 and dementia-related death was detected.
High random glucose levels measured in middle-aged but not older age persons without known diabetes mellitus were associated with greater risk of dementia-related death up to four decades later.
探讨中老年人群随机测量血糖水平与痴呆相关死亡之间的关联。
基于人群的队列研究。
挪威郡县研究（中年个体；35 - 49岁）和挪威队列研究参与者（老年个体；65 - 80岁）。
无已知糖尿病（n = 74,630）和有已知糖尿病（n = 3,095）的个体（N = 77,725）；完整病例分析纳入了67,865名无糖尿病和2,341名有糖尿病的个体（所有纳入协变量均无缺失），其中1,580名无糖尿病和131名有糖尿病的个体死于痴呆相关原因。
根据挪威死亡原因登记处确定痴呆相关死亡。采用Cox回归评估无糖尿病和有糖尿病个体的随机血糖水平（非空腹）与痴呆相关死亡之间的关系，并对教育程度、吸烟、心血管疾病、体重指数、胆固醇、血压和身体活动进行了校正。
在完全校正模型中，中年无糖尿病且血糖水平在6.5至11.0 mmol/L之间的个体，与血糖水平低于5.1 mmol/L的个体相比，痴呆相关死亡风险显著更高（风险比 = 1.32，95%置信区间 = 1.04 - 1.67）。观察到剂量反应关系（P = 0.02）。未检测到65至80岁个体的高血糖水平与痴呆相关死亡之间存在显著关联。
在无已知糖尿病的中年而非老年人群中测量到的高随机血糖水平，与长达四十年后的痴呆相关死亡风险增加有关。
