Diabetes mellitus and risk of Alzheimer's disease and dementia with stroke in a multiethnic cohort
Diabetes mellitus and risk of Alzheimer's disease and dementia with stroke in a multiethnic cohort
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DOI：
10.1093/aje/154.7.635
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发表时间：
2001-10-01
影响因子：
5
通讯作者：
Mayeux, R
中科院分区：
文献类型：
--
作者：
Luchsinger, JA;Tang, MX;Mayeux, R
关于糖尿病和痴呆之间关系的研究产生了相互矛盾的结果，并且尚未调查黑人和西班牙裔之间的关系。在这项研究中，Cox比例风险模型用于分析1992年至1997年平均随访4.3年的1262名基线（1991-1996年）无痴呆的老年受试者的纵向数据。结果是发生阿尔茨海默病和与中风相关的痴呆。基线时糖尿病患病率为20%。糖尿病患者与非糖尿病患者相比，阿尔茨海默病的校正相对危险度为1.3（95%可信区间：0.8,1.9）。在糖尿病患者中，阿尔茨海默病和无痴呆的认知障碍（无卒中）复合结局的调整相对风险为1.6 （95% CI: 1.2, 2.1）。糖尿病患者卒中相关痴呆的校正相对危险度为3.4 （95% CI: 1.7, 6.9）。在黑人和西班牙裔中，大约三分之一的卒中相关痴呆风险可归因于糖尿病（分别为33% （95% CI: 31, 36）和36% (95% CI: 33, 37)），而在白人中，这一比例为17% （95% CI: 13, 22）。糖尿病与阿尔茨海默病和无痴呆（无卒中）认知障碍的复合结局之间存在关联，这一发现与先前关于糖尿病与阿尔茨海默病之间存在适度关系的报道一致。
Research on the relation between diabetes mellitus and dementia has produced conflicting results, and the relation has not been investigated among Blacks and Hispanics. In this study, Cox proportional hazards models were used to analyze longitudinal data from 1,262 elderly subjects without dementia at baseline (1991-1996) who were followed for an average of 4.3 years between 1992 and 1997. Outcomes were incident Alzheimer's disease and dementia associated with stroke. The prevalence of diabetes was 20% at baseline. The adjusted relative risk of Alzheimer's disease among persons with diabetes as compared with those without diabetes was 1.3 (95% confidence interval (CI): 0.8, 1.9). The adjusted relative risk for the composite outcome of Alzheimer's disease and cognitive impairment without dementia (without stroke) in subjects with diabetes was 1.6 (95% CI: 1.2, 2.1). The adjusted relative risk of stroke-associated dementia in persons with diabetes was 3.4 (95% CI: 1.7, 6.9). Among Blacks and Hispanics, approximately one third of the risk of stroke-associated dementia was attributable to diabetes (33% (95% CI: 31, 36) and 36% (95% CI: 33, 37), respectively), as compared with 17% (95% CI: 13, 22) among Whites. The finding of an association between diabetes and the composite outcome of Alzheimer's disease and cognitive impairment without dementia (without stroke) is consistent with prior reports of a modest relation between diabetes and Alzheimer's disease.