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中年空腹血糖水平与晚年认知功能的关系:爱知职工队列研究。

Relationship Between Fasting Blood Glucose Levels in Middle Age and Cognitive Function in Later Life: The Aichi Workers' Cohort Study.

机构信息

Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine.

Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University.

出版信息

J Epidemiol. 2023 Feb 5;33(2):76-81. doi: 10.2188/jea.JE20210128. Epub 2021 Oct 29.

Abstract

BACKGROUND

There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers' Cohort Study in Japan.

METHODS

Participants were 253 former local government employees aged 60-79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate.

RESULTS

The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29.

CONCLUSION

FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.

摘要

背景

关于中年时期糖尿病(DM)与随访后轻度认知障碍之间的关系,目前相关证据有限。因此,我们在日本爱知职工队列研究中进行了超过 15 年的随访后,调查了中年空腹血糖(FBG)水平与晚年使用日本蒙特利尔认知评估(MoCA-J)评估的认知功能之间的关系。

方法

2018 年,我们纳入了 253 名年龄在 60-79 岁之间、曾在 2002 年参加过基线调查的前地方政府雇员。根据基线 FBG 水平和自我报告的病史,参与者被分为正常、空腹血糖受损(IFG)和糖尿病(DM)组。MoCA-J 的总分范围为 0 至 30 分,在本研究中,认知障碍定义为 MoCA-J 得分≤25 分。我们采用一般线性模型来估计 FBG 组的 MoCA-J 总分,调整了年龄、性别、受教育年限、吸烟状况、饮酒情况、体力活动、体重指数、收缩压、总胆固醇和估计肾小球滤过率等因素。

结果

总体人群的 MoCA-J 平均得分为 25.0,MoCA-J 得分≤25 的患病率为 49.0%。多变量调整后的总 MoCA-J 得分在正常、IFG 和 DM 组中分别为 25.2、24.8 和 23.4。DM 组 MoCA-J 得分≤25 的比值比为 3.29。

结论

中年时期的 FBG 水平与晚年评估的总 MoCA-J 得分呈负相关,与混杂因素无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5af1/9794446/2d26f0e0fb24/je-33-076-g001.jpg

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