The Second Affiliated Hospital, Dalian Medical University, Dalian, China.
School of Public Health, Dalian Medical University, Dalian, China.
Psychogeriatrics. 2022 Sep;22(5):666-678. doi: 10.1111/psyg.12869. Epub 2022 Jul 1.
Continuous hyperglycaemia has been related with dementia. However, it remains unclear whether prediabetes poses a higher risk of dementia. A meta-analysis was therefore conducted to comprehensively investigate the possible role of prediabetes as a risk factor of dementia.
Prospective cohort studies reporting the association of prediabetes and dementia were identified from PubMed, Web of Science, and Embase databases. A random-effects model was applied to combine the results by incorporating the influence of heterogeneity. Subgroup analyses were also conducted to explore the influences of study features on the relationship. Sensitivity analysis re-estimated the combined effect size after excluding single studies separately to explore the robustness of the results.
Nine studies involving 29 986 adults from the general population, 6265 (20.9%) of whom had prediabetes, were included. It was shown that prediabetes was not independently associated with a higher incidence of dementia compared with normoglycaemia (adjusted risk ratio (RR): 1.01, 95% confidence interval (CI): 0.85-1.21, P = 0.89, I = 39%). Subgroup analyses according to the definitions of prediabetes, follow-up duration, method for diagnosis of dementia, and quality score produced similar findings (P for all subgroup differences >0.05). In addition, prediabetes was not independently associated with the incidence of Alzheimer's disease (RR: 1.24, 95% CI: 0.98-1.56, P = 0.07, I = 0%) or vascular dementia (RR: 1.16, 95% CI: 0.70-1.92, P = 0.56, I = 0%). Different definitions of prediabetes have the potential to influence the results, as reflected in the subgroup analysis for Alzheimer's disease (RR: 1.30, 95% CI: 1.06-1.60, P = 0.01, I = 0%).
Prediabetes may not be an independent risk factor of all-cause dementia or vascular dementia in the general adult population. However, changing the definition of prediabetes may have an impact on the outcome for Alzheimer's disease.
持续高血糖与痴呆有关。然而，目前尚不清楚糖尿病前期是否会增加痴呆的风险。因此，进行了一项荟萃分析，以全面研究糖尿病前期作为痴呆风险因素的可能作用。
从 PubMed、Web of Science 和 Embase 数据库中确定了报告糖尿病前期与痴呆之间关联的前瞻性队列研究。应用随机效应模型，通过纳入异质性的影响来合并结果。还进行了亚组分析，以探讨研究特征对关系的影响。敏感性分析在分别排除单个研究后重新估计合并效应大小，以探索结果的稳健性。
纳入了 9 项研究，共涉及来自普通人群的 29986 名成年人，其中 6265 人（20.9%）患有糖尿病前期。结果表明，与正常血糖相比，糖尿病前期与痴呆发生率的增加无关（调整后的风险比（RR）：1.01，95%置信区间（CI）：0.85-1.21，P=0.89，I²=39%）。根据糖尿病前期的定义、随访时间、痴呆诊断方法和质量评分进行的亚组分析得出了类似的发现（所有亚组差异的 P 值均>0.05）。此外，糖尿病前期与阿尔茨海默病的发生率无关（RR：1.24，95%CI：0.98-1.56，P=0.07，I²=0%）或血管性痴呆（RR：1.16，95%CI：0.70-1.92，P=0.56，I²=0%）。不同的糖尿病前期定义可能会影响结果，这反映在阿尔茨海默病的亚组分析中（RR：1.30，95%CI：1.06-1.60，P=0.01，I²=0%）。
在普通成年人群中，糖尿病前期可能不是全因痴呆或血管性痴呆的独立危险因素。然而，改变糖尿病前期的定义可能会对阿尔茨海默病的结果产生影响。
