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.
Front Endocrinol (Lausanne). 2021 Apr 30;12:637392. doi: 10.3389/fendo.2021.637392. eCollection 2021.
Animal studies suggested that vildagliptin might exert a beneficial effect on cognitive function. The present study evaluated whether the use of vildagliptin in patients with type 2 diabetes mellitus might affect dementia risk.
The database of Taiwan's National Health Insurance was used to enroll an unmatched cohort and a propensity score-matched-pair cohort of ever and never users of vildagliptin from patients with newly diagnosed diabetes mellitus during 2002-2014. The patients should be alive on January 1, 2015 and were followed up for dementia diagnosis until December 31, 2016. Unadjusted and multivariate-adjusted hazard ratios (HR) and their 95% confidence intervals (CI) were estimated for vildagliptin ever never users, for cumulative duration and cumulative dose of vildagliptin therapy categorized into tertiles never users, and for cumulative duration and cumulative dose treated as continuous variables.
There were 355610 never users and 43196 ever users in the unmatched cohort and 40489 never users and 40489 ever users in the matched cohort. In the unmatched cohort, unadjusted HR (95% CI) was 0.929 (0.683-1.264) and the multivariate-adjusted HR (95% CI) was 0.922 (0.620-1.372). In the matched cohort, the unadjusted HR (95% CI) was 0.930 (0.616-1.402) and the multivariate-adjusted HR (95% CI) was 0.825 (0.498-1.367). None of the analyses conducted for cumulative duration and cumulative dose was significant, either being treated as tertile cutoffs or as continuous variables, in either the unmatched cohort or the matched cohort.
This study showed a neutral effect of vildagliptin on dementia risk.
动物研究表明维格列汀可能对认知功能有有益的影响。本研究评估了 2 型糖尿病患者使用维格列汀是否会影响痴呆风险。
利用台湾全民健康保险数据库，纳入了 2002 年至 2014 年间新诊断糖尿病患者中从未使用过和曾经使用过维格列汀的患者组成的非匹配队列和倾向评分匹配的对从未使用者的队列。这些患者应在 2015 年 1 月 1 日仍然存活，并随访至 2016 年 12 月 31 日，以诊断痴呆。对从未使用者的维格列汀使用者和维格列汀累积治疗时间和累积剂量进行分层为三分位数从未使用者，对累积治疗时间和累积剂量进行连续变量处理，估计未调整和多变量调整后的危险比（HR）及其 95%置信区间（CI）。
在非匹配队列中，有 355610 名从未使用者和 43196 名曾经使用者，在匹配队列中，有 40489 名从未使用者和 40489 名曾经使用者。在非匹配队列中，未调整 HR（95%CI）为 0.929（0.683-1.264），多变量调整 HR（95%CI）为 0.922（0.620-1.372）。在匹配队列中，未调整 HR（95%CI）为 0.930（0.616-1.402），多变量调整 HR（95%CI）为 0.825（0.498-1.367）。在非匹配队列和匹配队列中，无论作为三分位数截断值还是作为连续变量处理，累积治疗时间和累积剂量的分析均无显著意义。
本研究表明维格列汀对痴呆风险无明显影响。
