Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China.
Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
J Alzheimers Dis. 2019;67(4):1255-1265. doi: 10.3233/JAD-180662.
Several studies have demonstrated that the elevated fasting blood glucose (FBG) may increase the risk of incident dementia in older adults with or without diabetes mellitus (DM). However, similar results are rarely reported in Chinese population.
This study aimed to demonstrate the association between FBG and risk of incident cognitive decline in older Chinese adults.
We prospectively followed up 1,555 dementia-free participants with baseline FBG measurement in the Shanghai Aging Study.
We identified 126 incident dementia cases across a mean of 5.2 years. Cumulative dementia incidence in type II DM participants with higher FBG (>6.1 mmol/L) increased most dramatically, second with that of non-DM participants with higher FBG, than that of participants with lower FBG (≤6.1 mmol/L). DM participants had a significant higher risk of incident dementia (adjusted HR 1.51, 95% CI 1.25-1.82) by every 1 mmol/L increment of FBG. Among DM participants, baseline FBG was positively related to the rate of annual decline of MMSE (β= 0.10, p = 0.0018).
Our results suggest that especially in people with type II DM, effective blood glucose control may help to prevent cognitive impairment in later life.
多项研究表明，空腹血糖（FBG）升高可能会增加有或无糖尿病（DM）的老年人发生痴呆的风险。然而，在中国人群中很少有类似的结果报道。
本研究旨在证明 FBG 与中国老年成年人认知能力下降风险之间的关联。
我们前瞻性地随访了上海老龄化研究中基线 FBG 测量的 1555 名无痴呆症的参与者。
我们在平均 5.2 年的时间内确定了 126 例新发痴呆病例。在 FBG 较高（>6.1mmol/L）的 II 型 DM 参与者中，累积痴呆发病率增加最为显著，其次是 FBG 较高的非 DM 参与者，而 FBG 较低（≤6.1mmol/L）的参与者则较低。每增加 1mmol/L 的 FBG，DM 参与者新发痴呆的风险显著增加（调整后的 HR 1.51，95%CI 1.25-1.82）。在 DM 参与者中，基线 FBG 与 MMSE 的年下降率呈正相关（β=0.10，p=0.0018）。
我们的研究结果表明，特别是在 II 型 DM 患者中，有效的血糖控制可能有助于预防晚年的认知障碍。
