Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
J Diabetes. 2023 Feb;15(2):97-109. doi: 10.1111/1753-0407.13352. Epub 2023 Jan 20.
Type 2 diabetes mellitus (T2DM) and dementia cause heavy health burden in mainland China, where few studies have investigated the association between glucose-lowering agents and dementia risk. We aimed to assess the association between use of thiazolidinediones (TZDs) and dementia incidence in a mainland Chinese population with T2DM.
A retrospective cohort of T2DM patients who were new users of TZDs or alpha glucosidase inhibitors (AGIs) was assembled using the Yinzhou Regional Health Care Database. A Cox model with inverse probability of treatment weighting (IPTW) for controlling potential founding was applied to estimate the hazard ratio (HR) of the association between use of TZDs and dementia risk.
A total of 49 823 new users of AGIs and 12 752 new users of TZDs were included in the final cohort. In the primary analysis, the incidence of dementia was 195.7 and 78.2 per 100 000 person-years in users of AGIs and TZDs respectively. TZD use was associated with a reduced risk of incident dementia after adjusting for potential confounding using IPTW, with a HR of 0.51 (95% CI, 0.38-0.67). The results in various subgroup analyses and sensitivity analyses were consistent with the findings of the primary analysis.
Use of TZDs is associated with a decreased risk of dementia incidence in a mainland Chinese population with T2DM.
2 型糖尿病（T2DM）和痴呆在中国内地造成了沉重的健康负担，而很少有研究调查过降糖药物与痴呆风险之间的关系。我们旨在评估在患有 T2DM 的中国大陆人群中，使用噻唑烷二酮类（TZDs）与痴呆发病风险之间的关系。
使用鄞州区卫生保健数据库，组建了一个新使用 TZDs 或α葡萄糖苷酶抑制剂（AGIs）的 T2DM 患者回顾性队列。采用逆概率治疗加权（IPTW）的 Cox 模型来控制潜在混杂因素，以估计 TZDs 使用与痴呆风险之间的关联的风险比（HR）。
最终队列共纳入 49823 名新使用 AGIs 的患者和 12752 名新使用 TZDs 的患者。在主要分析中，AGIs 和 TZDs 使用者的痴呆发生率分别为每 100000 人年 195.7 和 78.2 例。使用 IPTW 调整潜在混杂因素后，TZDs 的使用与痴呆发病风险降低相关，HR 为 0.51（95%CI，0.38-0.67）。在各种亚组分析和敏感性分析中的结果与主要分析的结果一致。
在患有 T2DM 的中国大陆人群中，使用 TZDs 与痴呆发病风险降低相关。
