Hong Bin, Lee Hyesung, Choi Ahhyung, Kim Woo Jung, Cho Young Min, Yon Dong Keon, Shin Ju-Young
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea; Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea.
Diabetes Metab. 2024 Nov;50(6):101581. doi: 10.1016/j.diabet.2024.101581. Epub 2024 Sep 28.
To evaluate whether the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors which have shown potential neuroprotective effects, is associated with lower risk of dementia in patients with type 2 diabetes (T2D) and comorbid mental disorders, who are considerably more susceptible to dementia.
Using the nationwide healthcare data of South Korea between 2010 and 2022, we conducted a retrospective cohort study among patients with T2D and comorbid mental disorders initiating SGLT2 inhibitors versus active comparator (Dipeptidyl Peptidase IV (DPP4) inhibitors). Hazard ratios (HRs) and rate differences (RDs) per 1000 person-years of incident dementia were estimated after weighting by propensity score fine stratification method.
Over a 4.8-year median follow-up, SGLT2 inhibitors were associated with a 12 % lower risk of dementia compared with DPP4 inhibitors (11.31 vs. 12.86 events per 1000 person years; HR 0.88, 95 % CI 0.84 to 0.92; RD -1.55, -2.13 to -0.97). The results were consistent when stratified by age, sex, individual component, severe mental disorders, presence of insulin, history of cardiovascular disease, or history of hypertension.
SGLT2 inhibitors versus DPP4 inhibitors were associated with a lower risk of incident dementia in patients with T2D and comorbid mental disorders. Further randomized controlled trials are required to confirm our findings.
评估已显示出潜在神经保护作用的钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂的使用，是否与2型糖尿病（T2D）合并精神障碍患者患痴呆症的较低风险相关，这类患者患痴呆症的易感性要高得多。
利用2010年至2022年韩国全国性医疗保健数据，我们对开始使用SGLT2抑制剂的T2D合并精神障碍患者与活性对照（二肽基肽酶IV（DPP4）抑制剂）进行了一项回顾性队列研究。通过倾向评分精细分层法加权后，估计每1000人年新发痴呆症的风险比（HRs）和率差（RDs）。
在4.8年的中位随访期内，与DPP4抑制剂相比，SGLT2抑制剂使痴呆症风险降低了12%（每1000人年发生11.31例与12.86例；HR 0.88，95%CI 0.84至0.92；RD -1.55，-2.13至-0.97）。按年龄、性别、个体成分、严重精神障碍、胰岛素使用情况、心血管疾病史或高血压史分层时，结果一致。
与DPP4抑制剂相比，SGLT2抑制剂与T2D合并精神障碍患者新发痴呆症的较低风险相关。需要进一步的随机对照试验来证实我们的发现。
