BMC Medicine:超50万人的大数据表明,无论血压高低,男性患痴呆症风险都较高!

2021-05-21 K.K MedSci原创

低血压和高血压都与男性患痴呆症的风险较高有关,但对女性而言,痴呆症的患病风险随血压升高而增加。

全球约有5000万痴呆症患者,预计到2050年将增加两倍。2018年11月,《柳叶刀》子刊在纳入2016年195个国家和地区的数据中,发现有2700万女性和1600万男性患有痴呆症。从1990~2016年,痴呆症患病人数增加了一倍多,并认为人口老龄化和增长是痴呆症增加的主要原因。痴呆症也是2016年死亡原因的第五大原因。《全球疾病、伤害和危险因素负担研究》(GBD)估计,从1990年~2016年的26年间,患病人数增加了一倍,痴呆症死亡人数增加了148%。

 

Global, regional, and national burden of Alzheimer's disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.The Lancet Neurology.DOI: 10.1016/S1474-4422(18)30403-4

2016年里与痴呆症最新年龄标准化全球流行率和死亡率女性高于男性。痴呆症的粗年发病率女性为5.88/万人,男性的粗年发病率为8.42/万人。5月19日,澳大利亚新南威尔士大学乔治全球健康研究所的研究人员发表在BMC Medicine上的期刊显示:低血压和高血压都与男性患痴呆症的风险较高有关,但对女性而言,痴呆症的患病风险随血压升高而增加。

 

Jessica Gong et al. Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank.BMC Medicine.DOI: 10.1186/s12916-021-01980-z

研究中,共有502,226人(54.4%为女性)被纳入分析,这些人之前没有被诊断为痴呆症。参与者的平均年龄为女性56.3岁,男性56.7岁,平均来看,女性的收缩压(SBP)和舒张压(DBP)较低,基线特征显示:女性患有糖尿病和中风的比例低于男性。在11.8年的中位随访中,记录了4068例(其中1866名女性)痴呆症的事件。

分析表明,女性痴呆症的危险比(HR)随着收缩压的增加而增加,而男性则是U型关系。对于舒张压,女性和男性的痴呆风险都有明显的U型关系。

中年心血管危险主要因素与痴呆症之间存在性别差异(粉色阴影区域表示女性,蓝色代表男性)

女性体重指数BMI每增加5 kg/m2 ,患痴呆症HR是1.05,男性为1.02。女性腰围每增加10cm患痴呆症HR是HR为1.08,男性为1.04。女性腰臀比每增加0.1的HR为1.20,男性为1.13。女性腰围与身高比每增加0.1,患痴呆症HR是1.18,男性为1.17。与健康体重相比,女性体重不足的HR为1.86,男性为1.51;超重的女性HR为0.92,男性为0.80;肥胖的女性HR为1.08,男性为0.92。有与健康体重相比,超重和肥胖者存在性别差异,在这些群体中的女性患痴呆症的风险更大。曲线显示,女性和男性的BMI与痴呆症风险之间存在J型关联。

与从不吸烟相比,吸烟的女性HR为1.49,男性为1.34;曾有过吸烟的女性HR为1.04,男性为1.12。对于患有1型糖尿病的患者来说,女性患痴呆症的HR为3.12,男性为2.86。对于患有2型糖尿病的患者来说,女性的HR为1.74,男性为1.92。

与最高社会经济地位(SES)相比,最低SES的HR在女性中是1.65,在男性中是1.59,而中等SES的HR在女性中是1.12,在男性中是1.17。

对于总胆固醇、高密度脂蛋白,没有证据表明与男女性的痴呆症有关,女性的低密度脂蛋白胆固醇可能与痴呆症有关;女性每增加每1 mmol / L,HR为1.06,而男性的HR为0.97,与男性相比,女性的低密度脂蛋白胆固醇与痴呆症风险更大有关。

此外,女性过往中风患痴呆症HR为2.65,男性中为2.43。有一些证据表明,糖尿病、吸烟、中风与血管性痴呆的关系可能比阿尔兹海默症的关联性更大。血管性痴呆(VD)是指由缺血性卒中、出血性卒中和造成记忆、认知和行为等脑区低灌注的脑血管疾病所致的严重认知功能障碍综合征。血压升高对血管性痴呆和阿尔兹海默症的影响的性别差异是一致的。

研究人员认为,与女性相比,采用个性化的方法来治疗男性血压可能会预防痴呆症。

尽管没有有效的治疗痴呆症的方法,但是通过更健康的生活方式来减轻疾病负担也是最有效的方法,至少健康的生活方式可以预防疾病。

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    2021-06-17 jeanqiuqiu
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    2021-08-28 Boyinsh
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    2022-05-05 kalseyzl
  5. [GetPortalCommentsPageByObjectIdResponse(id=1859146, encodeId=3cc81859146fb, content=<a href='/topic/show?id=e0a9593596' target=_blank style='color:#2F92EE;'>#DIC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5935, encryptionId=e0a9593596, topicName=DIC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Thu Jun 17 12:07:21 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1975086, encodeId=578b19e5086ae, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Oct 26 18:07:21 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836260, encodeId=ed9918362601b, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Sat Aug 28 22:07:21 CST 2021, time=2021-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1773949, encodeId=e7b21e73949fb, content=<a href='/topic/show?id=5f014e1852' target=_blank style='color:#2F92EE;'>#CIN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4718, encryptionId=5f014e1852, topicName=CIN)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9a038523631, createdName=kalseyzl, createdTime=Thu May 05 07:07:21 CST 2022, time=2022-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577802, encodeId=34a615e780287, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Sat May 22 08:07:21 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611060, encodeId=d65e16110603d, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat May 22 08:07:21 CST 2021, time=2021-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048790, encodeId=aecc1048e907c, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Thu May 20 20:07:21 CST 2021, time=2021-05-20, status=1, ipAttribution=)]
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    2021-05-20 junJUN

    老年人痴呆何药可用??

    0

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