Tseng Chin-Hsiao
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Aging (Albany NY). 2019 May 14;11(9):2724-2734. doi: 10.18632/aging.101944.
This study investigated whether rosiglitazone might increase or reduce dementia risk. Taiwan's National Health Insurance database was used to enroll a cohort of 1:1 matched-pairs of ever and never users of rosiglitazone based on propensity score from patients with new-onset type 2 diabetes during 1999-2006. The patients were alive on January 1, 2007 and were followed up for dementia until December 31, 2011. A total of 5,048 pairs of never users and ever users were identified. The incident case numbers were 127 and 121, respectively. The adjusted hazard ratio for ever versus never users was 0.895 (95% confidence interval: 0.696-1.151). The adjusted hazard ratios for the first (<12.1 months), second (12.1-25.1 months) and third (>25.1 months) tertiles of cumulative duration of rosiglitazone therapy were 0.756 (0.509-1.123), 0.964 (0.685-1.357) and 0.949 (0.671-1.341), respectively. When cumulative duration was treated as a continuous variable, the adjusted hazard ratio was 1.000 (0.992-1.008). Subgroup analyses conducted in ever users and never users of metformin and in patients diagnosed with diabetes during three different periods of time, i.e., 1999-2000, 2001-2003 and 2004-2006, all supported a neutral effect of rosiglitazone. In conclusion, rosiglitazone does not increase or redcue the risk of dementia.
本研究调查了罗格列酮是否会增加或降低痴呆风险。利用台湾国民健康保险数据库,根据1999 - 2006年新诊断2型糖尿病患者的倾向评分,纳入一组罗格列酮使用者和非使用者1:1匹配对。患者在2007年1月1日仍存活,并随访至2011年12月31日以观察痴呆情况。共识别出5048对非使用者和使用者。新发病例数分别为127例和121例。使用者与非使用者的校正风险比为0.895(95%置信区间:0.696 - 1.151)。罗格列酮治疗累积时长的第一个(<12.1个月)、第二个(12.1 - 25.1个月)和第三个(>25.1个月)三分位数的校正风险比分别为0.756(0.509 - 1.123)、0.964(0.685 - 1.357)和0.949(0.671 - 1.341)。当累积时长作为连续变量处理时,校正风险比为1.000(0.992 - 1.008)。在二甲双胍使用者和非使用者以及在三个不同时间段(即1999 - 2000年、2001 - 2003年和2004 - 2006年)诊断为糖尿病的患者中进行的亚组分析均支持罗格列酮的中性作用。总之,罗格列酮不会增加或降低痴呆风险。