Hsieh Tsung-Cheng, Chen Hsiang-Hao, Chang Wei-Chuan, Ho Chen-Pei
Institute of Medical Sciences, Tzu Chi University, Hualien City, Taiwan.
Department of Public Health, Tzu Chi University, Hualien City, Taiwan.
Alzheimers Dement. 2025 Aug;21(8):e70590. doi: 10.1002/alz.70590.
This study examined the association between metformin-based oral antihyperglycemic combination therapy and the risk of developing dementia in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
We conducted a retrospective cohort study using data from a random sample of 2,000,000 individuals in Taiwan's National Health Insurance Research Database from 2000 to 2018. A total of 44,073 patients with newly diagnosed T2DM were identified and categorized into four groups based on initial treatment: metformin (MET)-sulfonylureas (SU), MET-dipeptidyl peptidase-4 inhibitor (DPP4i), MET-thiazolidinedione (TZD), and MET-glinides. The participants were followed until December 2018.
The hazard ratio of MET-TZD was 0.73 (95% confidence interval [CI]: 0.57-0.94), of MET-DPP4i was 0.64 (95% CI: 0.52-0.79), and of MET-glinides was 1.14 (95% CI: 0.94-1.39).
The MET-DPP4i group had the lowest risk of dementia, followed by the MET-TZD group.
Newly diagnosed type 2 diabetes mellitus (T2DM) patients using metformin (MET)-glinides and MET-sulfonylureas are at an increased risk of dementia. The MET-glinides group had the highest risk of dementia. The MET-dipeptidyl peptidase-4 inhibitor group had the lowest risk of dementia, followed by the MET-thiazolidinedione group.
本研究探讨了基于二甲双胍的口服降糖联合治疗与新诊断的2型糖尿病（T2DM）患者发生痴呆风险之间的关联。
我们进行了一项回顾性队列研究，使用了来自台湾国民健康保险研究数据库2000年至2018年随机抽取的200万个体的数据。共识别出44073例新诊断的T2DM患者，并根据初始治疗将其分为四组：二甲双胍（MET）-磺脲类（SU）、MET-二肽基肽酶-4抑制剂（DPP4i）、MET-噻唑烷二酮（TZD）和MET-格列奈类。对参与者进行随访至2018年12月。
MET-TZD组的风险比为0.73（95%置信区间[CI]：0.57 - 0.94），MET-DPP4i组为0.64（95%CI：0.52 - 0.79），MET-格列奈类组为1.14（95%CI：0.94 - 1.39）。
MET-DPP4i组痴呆风险最低，其次是MET-TZD组。
新诊断的2型糖尿病（T2DM）患者使用二甲双胍（MET）-格列奈类和MET-磺脲类会增加痴呆风险。MET-格列奈类组痴呆风险最高。MET-二肽基肽酶-4抑制剂组痴呆风险最低，其次是MET-噻唑烷二酮组。
