Risk of dementia among persons with diabetes mellitus: a population-based cohort study.
Risk of dementia among persons with diabetes mellitus: a population-based cohort study.
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DOI：
10.1093/oxfordjournals.aje.a009106
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发表时间：
1997-02
影响因子：
5
通讯作者：
C. Leibson;W. Rocca;V. Hanson;R. Cha;E. Kokmen;P. O'Brien;P. Palumbo
中科院分区：
文献类型：
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作者：
C. Leibson;W. Rocca;V. Hanson;R. Cha;E. Kokmen;P. O'Brien;P. Palumbo
目前还不清楚糖尿病患者是否会增加痴呆症的风险，包括阿尔茨海默病。现有的研究受到样本量小、选择偏倚和病例对照设计的限制。这项基于人群的历史队列研究提供了与成人发病糖尿病（AODM）相关的痴呆和阿尔茨海默病风险的估计。样本包括1970年1月1日居住在明尼苏达州罗切斯特的所有AODM患者，以及1970年1月1日至1984年12月31日期间在罗切斯特确诊或搬到罗切斯特确诊的所有患者。个体通过审查他们从AODM诊断到痴呆发作、移民、死亡或1985年1月1日的完整医疗记录进行随访。使用基于罗切斯特人群年龄和性别特异性发病率的预期发病率，计算痴呆和阿尔茨海默病的标准化发病率。Poisson回归用于估计AODM患者相对于非AODM患者的风险。在1，455例AODM病例中，随访9，981人年，其中101例出现痴呆症，其中77例符合阿尔茨海默病标准。AODM患者发生所有痴呆的风险显著增加（Poisson回归相对风险（RR）= 1.66，95%置信区间（CI）1.34-2.05）。阿尔茨海默病的风险也升高（男性，R = 2.27，95% CI 1.55-3.31;女性，RR = 1.37，95% CI 0.94-2.01）。这些发现强调了AODM预防的重要性，并提示进一步研究AODM和痴呆之间的关系。
It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population-based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, R = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.