Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2023 Nov 23;13(1):20600. doi: 10.1038/s41598-023-47566-y.
The relationship between prediabetes and dementia remains controversial. We aimed to examine the association between cumulative exposure to impaired fasting glucose (IFG) and the risk of dementia in the general population. 1,463,066 middle-aged and elderly subjects who had had health examinations for four consecutive years were identified from a Korean nationwide population-based cohort database. IFG was defined as fasting blood glucose 100-125 mg/dL, and the risk of dementia-according to the number of IFG exposure (range 0-4)-was analyzed using the multivariable Cox proportional-hazards model. During the median 6.4 years of follow-up, 7614 cases of all-cause dementia, 5603 cases of Alzheimer's disease, and 1257 cases of vascular dementia occurred. There was a significant trend towards a higher risk of all-cause dementia (P for trend = 0.014) and Alzheimer's disease ( Pfor trend = 0.005) according to the cumulative exposure to IFG, but with a modest (approximately 7-14%) increase in the hazards. A significant stepwise increase in the risk of all-cause dementia and Alzheimer's disease was seen in non-obese subjects, whereas no significant association was observed in obese subjects. This study supports the association between prediabetes and incident dementia and emphasizes that even mild hyperglycemia should not be overlooked.
空腹血糖受损与痴呆之间的关系仍存在争议。本研究旨在探讨中老年人群中空腹血糖受损（IFG）的累积暴露与痴呆风险之间的关系。
我们从韩国全国人群队列数据库中确定了 1463066 名连续 4 年接受健康检查的中老年人。IFG 的定义为空腹血糖 100-125mg/dL，使用多变量 Cox 比例风险模型分析根据 IFG 暴露次数（范围 0-4）预测的痴呆风险。在中位随访 6.4 年期间，发生了 7614 例全因痴呆、5603 例阿尔茨海默病和 1257 例血管性痴呆。根据 IFG 的累积暴露，全因痴呆（趋势 P=0.014）和阿尔茨海默病（趋势 P=0.005）的风险呈显著上升趋势，但风险增加幅度适中（约 7-14%）。在非肥胖人群中，全因痴呆和阿尔茨海默病的风险呈显著逐步上升趋势，而在肥胖人群中未观察到显著相关性。
本研究支持糖尿病前期与新发痴呆之间的关联，并强调即使是轻度高血糖也不应被忽视。
