葡萄糖钠转运体 2 抑制剂与二肽基肽酶 IV 抑制剂以及 2 型糖尿病合并精神障碍患者的痴呆风险：基于人群的队列研究

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2024-09-28 DOI:10.1016/j.diabet.2024.101581

Bin Hong , Hyesung Lee , Ahhyung Choi , Woo Jung Kim , Young Min Cho , Dong Keon Yon , Ju-Young Shin

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引用次数: 0

摘要

目的：评估具有潜在神经保护作用的钠-葡萄糖共转运体-2（SGLT2）抑制剂的使用是否与2型糖尿病（T2D）患者痴呆风险的降低有关：我们利用 2010 年至 2022 年期间韩国全国范围内的医疗保健数据，对开始服用 SGLT2 抑制剂和活性比较药（二肽基肽酶 IV (DPP4) 抑制剂）的 T2D 和合并精神障碍患者进行了一项回顾性队列研究。通过倾向评分精细分层法进行加权后，估算了每千人年痴呆症发病率的危险比（HRs）和比率差异（RDs）：在4.8年的中位随访期间，与DPP4抑制剂相比，SGLT2抑制剂的痴呆风险降低了12%（11.31 vs. 12.86次/1000人年；HR 0.88，95% CI 0.84 to 0.92；RD -1.55, -2.13 to -0.97）。按年龄、性别、个体成分、严重精神障碍、是否使用胰岛素、心血管疾病史或高血压史进行分层后，结果一致：SGLT2抑制剂与DPP4抑制剂相比，可降低合并精神障碍的T2D患者发生痴呆症的风险。需要进一步的随机对照试验来证实我们的研究结果。

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查看原文本刊更多论文

Sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase IV inhibitors and risk of dementia among patients with type 2 diabetes and comorbid mental disorders: A population-based cohort study

Aim

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.

Methods

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.

Results

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.

Conclusions

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.

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.