Pre-eclampsia and risk of dementia later in life: nationwide cohort study.
Pre-eclampsia and risk of dementia later in life: nationwide cohort study.
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DOI：
10.1136/bmj.k4109
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发表时间：
2018-10-17
期刊：
影响因子：
--
通讯作者：
Boyd HA
中科院分区：
文献类型：
--
作者：
Basit S;Wohlfahrt J;Boyd HA
探索先兆子痫和晚期痴呆之间的关系，总体和痴呆亚型和发病时间。全国范围内基于登记的队列研究。丹麦。1978年至2015年期间至少有一次活产或死胎的所有妇女。采用考克斯回归法对有和无先兆子痫病史的妇女痴呆发生率进行比较的风险比该队列包括1 178 005名女性，随访20 352 695人年。与无先兆子痫病史的女性相比，有先兆子痫病史的女性在以后的生活中患血管性痴呆的风险是无先兆子痫病史的女性的三倍多（风险比3.46，95%置信区间1.97至6.10）。晚发性疾病与血管性痴呆的相关性（风险比6.53，2.82 - 15.1）似乎比早发性疾病（2.32，1.06 - 5.06）更强（P=0.08）。调整糖尿病、高血压和心血管疾病仅适度降低风险比;敏感性分析表明，体重指数不太可能解释与血管性痴呆的关系。相比之下，阿尔茨海默病（风险比1.45，1.05至1.99）和其他/未指明的痴呆（1.40，1.08至1.83）仅观察到适度的相关性。先兆子痫与痴呆的风险增加有关，特别是血管性痴呆。心血管疾病、高血压和糖尿病不太可能介导实质性的相关性，这表明先兆子痫和血管性痴呆可能共享潜在的机制或易感性途径。询问先兆子痫的病史可以帮助医生确定哪些妇女可能受益于筛查疾病的早期迹象，从而进行早期临床干预。
To explore associations between pre-eclampsia and later dementia, overall and by dementia subtype and timing of onset. Nationwide register based cohort study. Denmark. All women with at least one live birth or stillbirth between 1978 and 2015. Hazard ratios comparing dementia rates among women with and without a history of pre-eclampsia, estimated using Cox regression. The cohort consisted of 1 178 005 women with 20 352 695 person years of follow-up. Women with a history of pre-eclampsia had more than three times the risk of vascular dementia (hazard ratio 3.46, 95% confidence interval 1.97 to 6.10) later in life, compared with women with no history of pre-eclampsia. The association with vascular dementia seemed to be stronger for late onset disease (hazard ratio 6.53, 2.82 to 15.1) than for early onset disease (2.32, 1.06 to 5.06) (P=0.08). Adjustment for diabetes, hypertension, and cardiovascular disease attenuated the hazard ratios only moderately; sensitivity analyses suggested that body mass index was unlikely to explain the association with vascular dementia. In contrast, only modest associations were observed for Alzheimer’s disease (hazard ratio 1.45, 1.05 to 1.99) and other/unspecified dementia (1.40, 1.08 to 1.83). Pre-eclampsia was associated with an increased risk of dementia, particularly vascular dementia. Cardiovascular disease, hypertension, and diabetes were unlikely to mediate the associations substantially, suggesting that pre-eclampsia and vascular dementia may share underlying mechanisms or susceptibility pathways. Asking about a history of pre-eclampsia could help physicians to identify women who might benefit from screening for early signs of disease, allowing for early clinical intervention.
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DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
DOI：
10.1136/bmj.j3078
发表时间：
2017-07-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Behrens I;Basit S;Melbye M;Lykke JA;Wohlfahrt J;Bundgaard H;Thilaganathan B;Boyd HA
通讯作者：
Boyd HA
影响因子：
2.9
作者：
Nelander, M.;Cnattingius, S.;Wikstrom, A-K
通讯作者：
Wikstrom, A-K
影响因子：
2.4
作者：
Phung, Thien Kieu Thi;Andersen, Birgitte Bo;Waldemar, Gunhild
通讯作者：
Waldemar, Gunhild
影响因子：
9.8
作者：
Fields JA;Garovic VD;Mielke MM;Kantarci K;Jayachandran M;White WM;Butts AM;Graff-Radford J;Lahr BD;Bailey KR;Miller VM
通讯作者：
Miller VM