Susanna Satuli-Autere, Valma Harjutsalo, Marika I Eriksson, Stefanie Hägg-Holmberg, Hanna Öhman, Tor-Björn Claesson, Per-Henrik Groop, Lena M Thorn
{"title":"芬兰 1 型糖尿病患者神经退行性疾病发病率增加。","authors":"Susanna Satuli-Autere, Valma Harjutsalo, Marika I Eriksson, Stefanie Hägg-Holmberg, Hanna Öhman, Tor-Björn Claesson, Per-Henrik Groop, Lena M Thorn","doi":"10.1136/bmjdrc-2024-004024","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes is linked to neurodegenerative diseases (NDs), but data in type 1 diabetes are scarce. Our aim was to assess the standardized incidence ratios (SIRs) of different NDs in type 1 diabetes, and to evaluate the impact of diabetic vascular complications and age at diabetes onset.</p><p><strong>Research design and methods: </strong>In this observational cohort study, we included 4261 individuals with type 1 diabetes from the Finnish Diabetic Nephropathy study, and 11 653 matched population-based controls without diabetes. NDs were identified from registers until the end of 2017. Diabetic complications were assessed at the baseline study visit. SIRs were calculated from diabetes onset, except for impact of complications that was calculated from baseline study visit.</p><p><strong>Results: </strong>The SIRs for NDs were increased in type 1 diabetes: any dementia 2.24 (95% CI 1.79 to 2.77), Alzheimer's disease 2.13 (95% CI 1.55 to 2.87), vascular dementia 3.40 (95% CI 2.08 to 5.6), other dementias 1.70 (95% CI 1.22 to 2.31), and Parkinson's disease 1.61 (95% CI 1.04 to 2.37). SIR showed a twofold increased incidence already in those without albuminuria (1.99 (1.44-2.68)), but further increased in presence of diabetic complications: kidney disease increased SIR for Alzheimer's disease, while cardiovascular disease increased SIR for both Alzheimer's disease and other dementias. Diabetes onset <15 years, compared with ≥15 years, increased SIR of Alzheimer's disease, 3.89 (2.21-6.35) vs 1.73 (1.16-2.48), p<0.05, but not the other dementias.</p><p><strong>Conclusions: </strong>ND incidence is increased 1.7-3.4-fold in type 1 diabetes. The presence of diabetic kidney disease and cardiovascular disease further increased the incidence of dementia.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381727/pdf/","citationCount":"0","resultStr":"{\"title\":\"Increased incidence of neurodegenerative diseases in Finnish individuals with type 1 diabetes.\",\"authors\":\"Susanna Satuli-Autere, Valma Harjutsalo, Marika I Eriksson, Stefanie Hägg-Holmberg, Hanna Öhman, Tor-Björn Claesson, Per-Henrik Groop, Lena M Thorn\",\"doi\":\"10.1136/bmjdrc-2024-004024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Diabetes is linked to neurodegenerative diseases (NDs), but data in type 1 diabetes are scarce. Our aim was to assess the standardized incidence ratios (SIRs) of different NDs in type 1 diabetes, and to evaluate the impact of diabetic vascular complications and age at diabetes onset.</p><p><strong>Research design and methods: </strong>In this observational cohort study, we included 4261 individuals with type 1 diabetes from the Finnish Diabetic Nephropathy study, and 11 653 matched population-based controls without diabetes. NDs were identified from registers until the end of 2017. Diabetic complications were assessed at the baseline study visit. SIRs were calculated from diabetes onset, except for impact of complications that was calculated from baseline study visit.</p><p><strong>Results: </strong>The SIRs for NDs were increased in type 1 diabetes: any dementia 2.24 (95% CI 1.79 to 2.77), Alzheimer's disease 2.13 (95% CI 1.55 to 2.87), vascular dementia 3.40 (95% CI 2.08 to 5.6), other dementias 1.70 (95% CI 1.22 to 2.31), and Parkinson's disease 1.61 (95% CI 1.04 to 2.37). SIR showed a twofold increased incidence already in those without albuminuria (1.99 (1.44-2.68)), but further increased in presence of diabetic complications: kidney disease increased SIR for Alzheimer's disease, while cardiovascular disease increased SIR for both Alzheimer's disease and other dementias. Diabetes onset <15 years, compared with ≥15 years, increased SIR of Alzheimer's disease, 3.89 (2.21-6.35) vs 1.73 (1.16-2.48), p<0.05, but not the other dementias.</p><p><strong>Conclusions: </strong>ND incidence is increased 1.7-3.4-fold in type 1 diabetes. The presence of diabetic kidney disease and cardiovascular disease further increased the incidence of dementia.</p>\",\"PeriodicalId\":9151,\"journal\":{\"name\":\"BMJ Open Diabetes Research & Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381727/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open Diabetes Research & Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjdrc-2024-004024\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Diabetes Research & Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjdrc-2024-004024","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
简介:糖尿病与神经退行性疾病(NDs)有关:糖尿病与神经退行性疾病(NDs)有关,但有关1型糖尿病的数据很少。我们的目的是评估 1 型糖尿病患者不同神经退行性疾病的标准化发病率(SIR),并评估糖尿病血管并发症和糖尿病发病年龄的影响:在这项观察性队列研究中,我们纳入了来自芬兰糖尿病肾病研究的 4261 名 1 型糖尿病患者和 11 653 名无糖尿病的匹配人群对照。肾病患者是从截至 2017 年底的登记册中确定的。糖尿病并发症在基线研究访问时进行评估。除并发症的影响从基线研究访问开始计算外,其他SIR均从糖尿病发病开始计算:结果:1型糖尿病患者的非痴呆症SIR增加:任何痴呆症2.24(95% CI 1.79至2.77),阿尔茨海默病2.13(95% CI 1.55至2.87),血管性痴呆症3.40(95% CI 2.08至5.6),其他痴呆症1.70(95% CI 1.22至2.31),帕金森病1.61(95% CI 1.04至2.37)。在没有白蛋白尿的情况下,SIR 的发生率已经增加了两倍(1.99 (1.44-2.68)),但在出现糖尿病并发症时,SIR 会进一步增加:肾脏疾病会增加阿尔茨海默病的 SIR,而心血管疾病会增加阿尔茨海默病和其他痴呆症的 SIR。糖尿病发病结论:1 型糖尿病患者的 ND 发病率增加 1.7-3.4 倍。糖尿病肾病和心血管疾病会进一步增加痴呆症的发病率。
Increased incidence of neurodegenerative diseases in Finnish individuals with type 1 diabetes.
Introduction: Diabetes is linked to neurodegenerative diseases (NDs), but data in type 1 diabetes are scarce. Our aim was to assess the standardized incidence ratios (SIRs) of different NDs in type 1 diabetes, and to evaluate the impact of diabetic vascular complications and age at diabetes onset.
Research design and methods: In this observational cohort study, we included 4261 individuals with type 1 diabetes from the Finnish Diabetic Nephropathy study, and 11 653 matched population-based controls without diabetes. NDs were identified from registers until the end of 2017. Diabetic complications were assessed at the baseline study visit. SIRs were calculated from diabetes onset, except for impact of complications that was calculated from baseline study visit.
Results: The SIRs for NDs were increased in type 1 diabetes: any dementia 2.24 (95% CI 1.79 to 2.77), Alzheimer's disease 2.13 (95% CI 1.55 to 2.87), vascular dementia 3.40 (95% CI 2.08 to 5.6), other dementias 1.70 (95% CI 1.22 to 2.31), and Parkinson's disease 1.61 (95% CI 1.04 to 2.37). SIR showed a twofold increased incidence already in those without albuminuria (1.99 (1.44-2.68)), but further increased in presence of diabetic complications: kidney disease increased SIR for Alzheimer's disease, while cardiovascular disease increased SIR for both Alzheimer's disease and other dementias. Diabetes onset <15 years, compared with ≥15 years, increased SIR of Alzheimer's disease, 3.89 (2.21-6.35) vs 1.73 (1.16-2.48), p<0.05, but not the other dementias.
Conclusions: ND incidence is increased 1.7-3.4-fold in type 1 diabetes. The presence of diabetic kidney disease and cardiovascular disease further increased the incidence of dementia.
期刊介绍:
BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of
high-quality — and evidence-based — original research articles.