来自德国的一项回顾性队列研究:SGLT2抑制剂治疗与老年2型糖尿病患者无痴呆生存期延长之间的关系

IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Theresia Sarabhai , Rebecca Zingel , Jens Bohlken , Karel Kostev
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引用次数: 0

摘要

背景:由于高血糖、胰岛素抵抗和血管功能障碍,2型糖尿病(T2DM)患者发生痴呆的风险增加。钠-葡萄糖共转运蛋白-2抑制剂(SGLT2i)可能具有超越葡萄糖控制的神经保护作用,但证据仍然有限。本研究旨在评估与二肽基肽酶-4抑制剂(DPP-4i)相比,老年T2DM患者使用SGLT2i是否与较低的痴呆发病率相关。方法:本回顾性队列研究使用来自德国IQVIA™疾病分析仪数据库的数据。年龄≥60 岁的T2DM患者,接受二甲双胍和新开的SGLT2i或DPP-4i(2012-2022)。既往有神经退行性诊断者排除在外。倾向评分匹配(1:1)和Cox比例风险模型用于估计5年以上痴呆的风险比(HR)。结果:匹配后纳入38140例患者。SGLT2i组痴呆发生率(5.4 %)低于DPP-4i组(6.4 %)(p = 0.002)。SGLT2i的使用与降低20% %痴呆风险相关(HR: 0.80; 95% % CI: 0.70-0.93; p = 0.002),特别是在80岁至 岁的患者(HR: 0.75)和男性(HR: 0.77)。结论:SGLT2i治疗与老年T2DM患者痴呆发生率降低相关,尤其是男性和高龄患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between SGLT2 inhibitor therapy and prolonged dementia-free survival in older adults with type 2 diabetes: a retrospective cohort study from Germany

Background

Patients with type 2 diabetes mellitus (T2DM) are at increased risk of dementia due to hyperglycemia, insulin resistance, and vascular dysfunction. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may have neuroprotective effects beyond glucose control, but evidence remains limited. This study aimed to assess whether SGLT2i use is associated with a lower incidence of dementia compared to dipeptidyl peptidase-4 inhibitors (DPP-4i) in older adults with T2DM.

Methods

This retrospective cohort study used data from the IQVIA™ Disease Analyzer database in Germany. Patients aged ≥60 years with T2DM, receiving metformin and newly prescribed SGLT2i or DPP-4i (2012–2022), were included. Those with prior neurodegenerative diagnoses were excluded. Propensity score matching (1:1) and Cox proportional hazards models were used to estimate hazard ratios (HR) for dementia over five years.

Results

After matching, 38,140 patients were included. Dementia incidence was lower in the SGLT2i group (5.4 %) than the DPP-4i group (6.4 %) (p = 0.002). SGLT2i use was linked to a 20 % reduced dementia risk (HR: 0.80; 95 % CI: 0.70–0.93; p = 0.002), especially in patients >80 years (HR: 0.75) and males (HR: 0.77).

Conclusions

SGLT2i therapy was associated with a lower incidence of dementia in older adults with T2DM, particularly in men and the very elderly.
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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