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基于韩国 NHIS-HEALS 队列研究,二甲双胍在老年糖尿病患者中的使用与痴呆风险呈剂量依赖性降低相关。

Metformin use in elderly population with diabetes reduced the risk of dementia in a dose-dependent manner, based on the Korean NHIS-HEALS cohort.

机构信息

Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Chungbuk, Republic of Korea.

Department of Information & Statistics, Chungbuk National University, Chungbuk, Cheongju, Republic of Korea.

出版信息

Diabetes Res Clin Pract. 2020 Dec;170:108496. doi: 10.1016/j.diabres.2020.108496. Epub 2020 Oct 15.

Abstract

AIMS

The aim of this study is to investigate the association between metformin usage and dementia in an elderly Korean population.

METHODS

Participants were divided into five groups: metformin non-users with diabetes mellitus (DM), metformin users with DM (low-, mid-, and high-users), and non-diabetic Individuals. Dementia was defined with primary diagnostic dementia codes according to the 10th edition of the International Classification of Diseases. To compare the incidence rate of dementia among the five groups, Kaplan-Meier estimates and log-rank test were employed. Also, to control the confounding factors, Cox proportional hazards regression models were fitted in a sequential adjustment.

RESULTS

The median follow-up was 12.4 years. The overall incidence rate of dementia was 11.3% (8.4% in men and 13.9% in women). Compared with metformin non-users, hazard ratios (95% confidence intervals) of low-, mid-, and high-users and non-diabetic individuals for dementia were 0.97 (0.73-1.28), 0.77 (0.58-1.01), 0.48 (0.35-0.67), and 0.98 (0.84-1.15), respectively, in men, respectively, and 0.90 (0.65-0.98), 0.61 (0.50-0.76), 0.46 (0.36-0.58), and 0.92 (0.81-1.04), respectively, in women, after full adjustment of confounding variables.

CONCLUSIONS

Metformin use in an elderly population with DM reduced dementia risk in a dose-response manner.

摘要

目的

本研究旨在探讨老年韩国人群中二甲双胍使用与痴呆的关系。

方法

参与者分为五组:糖尿病(DM)未使用二甲双胍组、DM 使用二甲双胍组(低、中、高剂量组)和非糖尿病个体组。痴呆症根据国际疾病分类第 10 版的主要诊断痴呆症代码定义。为了比较五组痴呆症的发生率,采用 Kaplan-Meier 估计和对数秩检验。此外,为了控制混杂因素,在序贯调整中拟合 Cox 比例风险回归模型。

结果

中位随访时间为 12.4 年。痴呆症的总发生率为 11.3%(男性为 8.4%,女性为 13.9%)。与二甲双胍未使用者相比,低、中、高剂量使用者和非糖尿病个体的男性痴呆症风险比(95%置信区间)分别为 0.97(0.73-1.28)、0.77(0.58-1.01)、0.48(0.35-0.67)和 0.98(0.84-1.15),女性分别为 0.90(0.65-0.98)、0.61(0.50-0.76)、0.46(0.36-0.58)和 0.92(0.81-1.04),在充分调整混杂变量后。

结论

在老年 DM 人群中使用二甲双胍以剂量反应的方式降低了痴呆风险。

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