Association between comorbidities and dementia in diabetes mellitus patients: population-based retrospective cohort study
Association between comorbidities and dementia in diabetes mellitus patients: population-based retrospective cohort study
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DOI：
10.1016/j.jdiacomp.2015.06.010
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发表时间：
2015-11-01
影响因子：
3
通讯作者：
Sung, Fung-Chung
中科院分区：
文献类型：
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作者：
Kuo, Shu-Chen;Lai, Shih-Wei;Sung, Fung-Chung
目的：大多数糖尿病 (DM) 患者都有多种合并症；这些合并症与糖尿病痴呆的相关性需要澄清。方法：利用台湾国民健康保险的索赔数据，我们识别了 2000 年之前的 33,709 名成年糖尿病患者，并随机选择了 67,066 名性别和年龄匹配的非糖尿病患者。对受试者进行随访直至诊断为痴呆，因死亡/退出保险计划而被排除，或随访至 2011 年。我们比较了两个队列中痴呆的发病率和风险比 (HR)。结果：糖尿病患者中合并症更为普遍，包括高血压、高脂血症、中风、冠状动脉和/或肾脏疾病。有合并症的 DM 队列的 HR 高于无合并症的 DM 队列：高血压为 1.88 vs. 1.46；高脂血症时为 1.56 vs. 1.39；冠状动脉疾病为 1.73 vs. 1.37；中风患者为 2.36 vs. 2.29，肾脏疾病患者为 1.88 vs. 1.50。糖尿病患者痴呆的 HR 从没有合并症的患者的 1.41 上升到有 >= 4 种合并症的患者的 2.49。在糖尿病队列中，非胰岛素使用者的 HR 为 1.22，胰岛素使用者的 HR 为 1.41，1 型糖尿病的 HR 为 1.49，2 型糖尿病的 HR 为 1.23。 结论：糖尿病患者患痴呆的风险较高，合并症会增加这种风险。 (C) 2015 Elsevier Inc. 保留所有权利。
Aims: Most diabetes mellitus (DM) patients have several comorbidities; the correlation of these comorbidities with dementia in DM requires clarification.Methods: Using claims data from Taiwan National Health Insurance, we identified 33,709 DM adults before the year 2000 and randomly selected 67,066 non-DM patients matched by sex and age. Subjects were followed until diagnosis with dementia, excluded due to death/withdrawal from the insurance program, or followed until 2011. We compared the incidence and hazard ratio (HR) for dementia in both cohorts.Results: Comorbidities were more prevalent in DM patients, including hypertension, hyperlipidemia, stroke, coronary artery and/or kidney disease. The HR was higher for the DM cohort with comorbidities than those without: 1.88 vs. 1.46 with hypertension; 1.56 vs. 1.39 with hyperlipidemia; 1.73 vs. 1.37 with coronary artery disease; 2.36 vs. 2.29 with stroke and 1.88 vs. 1.50 with kidney disease. The HR for dementia in diabetics rose from 1.41 in those without comorbidities to 2.49 in those with >= 4 comorbidities. In the DM cohort, HR was 1.22 for non-insulin-users and 1.41 for insulin-users, and 1.49 for type 1 DM and 1.23 for type 2 DM.Conclusion: Diabetic patients have an elevated risk of dementia, and comorbidity increases this risk. (C) 2015 Elsevier Inc. All rights reserved.