口服降糖药与 2 型糖尿病老年患者痴呆风险的关系。
Oral diabetes medication and risk of dementia in elderly patients with type 2 diabetes.
机构信息
College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea.
College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea; Department of Pharmacy, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea.
出版信息
Diabetes Res Clin Pract. 2019 Aug;154:116-123. doi: 10.1016/j.diabres.2019.07.004. Epub 2019 Jul 4.
AIM
To examine the effect of oral diabetes medication on the risk of dementia in an elderly cohort with type 2 diabetes.
METHODS
This was a population-based cohort study using the Korean National Health Insurance claims data from 2002 to 2013. Elderly subjects (60 years of age or older) with and without type 2 diabetes were included; patients with new-onset type 2 diabetes were further divided into the oral diabetes medication group and no-medication group.
RESULTS
Among 278,290 patients with type 2 diabetes, 56,587 developed dementia (20.3%) over 11 years of follow-up. Type 2 diabetes was associated with a 1.69-fold increased risk of dementia (95% CI 1.66-1.72). Among patients with newly diagnosed type 2 diabetes, the risk of dementia was lower in the oral diabetes medication group than in the no-medication group (adjusted hazard ratio [aHR], 0.79; 95% CI 0.77-0.81). Lower risk of dementia was particularly noticeable in all of the combination therapy groups and especially lower in the combination therapy group treated with dipeptidyl peptidase 4 inhibitor (aHR 0.48, 95% CI 0.45-0.51).
CONCLUSION
Overall, the use of oral diabetes medication in type 2 diabetes patients significantly decreased the risk of dementia.
目的
在 2 型糖尿病老年队列中，考察口服降糖药物对痴呆风险的影响。
方法
这是一项基于人群的队列研究，使用了 2002 年至 2013 年的韩国国家健康保险索赔数据。纳入了有和无 2 型糖尿病的老年患者（60 岁或以上）；新发 2 型糖尿病患者进一步分为口服降糖药物组和无药物组。
结果
在 278290 例 2 型糖尿病患者中，11 年的随访中有 56587 例（20.3%）发生了痴呆。2 型糖尿病使痴呆的风险增加了 1.69 倍（95%CI 1.66-1.72）。在新诊断的 2 型糖尿病患者中，与无药物组相比，口服降糖药物组痴呆的风险较低（校正后的危险比[aHR]，0.79；95%CI 0.77-0.81）。在所有联合治疗组中，痴呆风险降低更为显著，尤其是二肽基肽酶 4 抑制剂联合治疗组（aHR 0.48，95%CI 0.45-0.51）。
结论
总体而言，2 型糖尿病患者使用口服降糖药物可显著降低痴呆风险。
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