Yu Tung-Min, Chuang Ya-Wen, Huang Shih-Ting, Huang Jin-An, Chen Cheng-Hsu, Chung Mu-Chi, Wu Chun-Yi, Chang Pi-Yi, Hsu Chih-Cheng, Wu Ming-Ju
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung 40705, Taiwan.
Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404333, Taiwan.
Biomedicines. 2022 Aug 19;10(8):2015. doi: 10.3390/biomedicines10082015.
Contrast-medium-associated kidney injury is caused by the infusion of contrast media. Small vessel disease is significantly associated with various diseases, including simultaneous conditions of the kidney and brain, which are highly vulnerable to similar vascular damage and microvascular pathologies. Data to investigate the adverse effect of contrast media on the brain remain extremely lacking. In this study, 11,332,616 NHI enrollees were selected and divided into two groups, exposed and not exposed to a contrast medium during the observation period, from which 1,461,684 pairs were selected for analyses through matching in terms of age, sex, comorbidities, and frequency of outpatient visits during the previous year. In total, 1,461,684 patients exposed to a contrast medium and 1,461,684 controls not exposed to one were enrolled. In multivariable Cox proportional hazard models, patients exposed to a contrast medium had an overall 2.09-fold higher risk of dementia. In multivariable-stratified analyses, the risk of Alzheimer's disease was remarkably high in younger patients without any underlying comorbidity. This study is the first to discover that exposure to contrast media is significantly associated with the risk of dementia. A four-fold increased risk of vascular dementia was observed after exposure to a contrast medium. Further studies on the influence of exposure to contrast media on the brain are warranted.
造影剂相关性肾损伤是由造影剂输注引起的。小血管疾病与多种疾病显著相关，包括肾脏和大脑的同时发病情况，这些器官极易受到类似的血管损伤和微血管病变的影响。关于造影剂对大脑不良影响的研究数据仍然极为匮乏。在本研究中，选取了11332616名国民健康保险（NHI）参保者，并将其分为两组，即观察期内接触造影剂组和未接触造影剂组，从中通过年龄、性别、合并症以及上一年门诊就诊频率匹配选取了1461684对进行分析。总共纳入了1461684名接触造影剂的患者和1461684名未接触造影剂的对照组。在多变量Cox比例风险模型中，接触造影剂的患者患痴呆症的总体风险高出2.09倍。在多变量分层分析中，无任何基础合并症的年轻患者患阿尔茨海默病的风险显著较高。本研究首次发现接触造影剂与痴呆症风险显著相关。接触造影剂后观察到血管性痴呆风险增加了四倍。有必要进一步研究接触造影剂对大脑的影响。
