血糖状态、早发性和晚发性痴呆、无痴呆寿命和大脑结构：一项基于人群的队列研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-18 DOI:10.1016/j.diabres.2025.112909

Chenglong Li , Daijun He , Chao Yang , Luxia Zhang , Rodica Pop-Busui

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引用次数: 0

摘要

目的：评估血糖状态与早发性痴呆（EOD）和晚发性痴呆（LOD）、无痴呆预期寿命、脑MRI结构测量以及抑郁发作的介导途径的关系。方法：基于UK Biobank的人群队列研究，共纳入286 743名（平均[SD]年龄，51.5[5.9]岁）和330 103名（平均[SD]年龄，60.7[5.0]岁）参与者，分别分析EOD和LOD。事件性EOD定义为65岁前的痴呆诊断，LOD定义为65岁后的痴呆。结果：与血糖状况较差的糖尿病参与者相比，血糖控制最佳的糖尿病参与者的EOD发病率分别降低了47 %和17 %，50岁时无痴呆寿命延长了3.2 年，痴呆相关的脑结构测量也更好。抑郁发作介导的发生率分别为18.8 % （P = 0.014）和7.8 % （P ）。结论：较好的血糖状态与降低EOD和LOD风险、延长无痴呆寿命和脑MRI测量有关，部分由抑郁发作介导。这些发现支持了在早期症状前阶段达到理想血糖状态对预防痴呆发作和延长无痴呆寿命的潜在意义。

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Glycemic status, early-onset and late-onset dementia, dementia-free lifespan, and brain structure: A population-based cohort study

Aims

To evaluate associations of glycemic status with incident early-onset dementia (EOD) and late-onset dementia (LOD), dementia-free life expectancy, brain MRI structure measures, as well as the mediation pathway of depressive episode.

Methods

A population-based cohort study based on UK Biobank, enrolling a total of 286 743 (mean [SD] age, 51.5 [5.9] years) and 330 103 participants (mean [SD] age, 60.7 [5.0] years) for analyzing EOD and LOD, respectively. Incident EOD was defined as dementia diagnosis before age 65, and LOD defined as dementia after age 65.

Results

Diabetes participants with optimal glycemic control respectively had a 47 % lower EOD incidence and a 17 % lower LOD incidence, up to 3.2 years longer dementia-free lifespan at age 50, and better dementia-related brain structure measures, compared to counterparts with worse glycemic status. Incident depressive episode mediated 18.8 % (P = 0.014) and 7.8 % (P < 0.001) of associations between glycemic status with EOD and LOD, respectively.

Conclusions

Better glycemic status was associated with reduced EOD and LOD risks, prolonged dementia-free lifespan, and brain MRI measures, partiality mediated by depressive episode. These findings support the potential significance of reaching ideal glycemic status to prevent dementia onset and prolong dementia-free longevity at the early pre-symptomatic stage in young diabetes.

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来源期刊

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.