Diabetes Care:1型糖尿病患者血糖长期控制稳定可以降低痴呆的风险!

2021-09-02 从医路漫漫 MedSci原创

目前认为糖尿病同痴呆有一定的联系,虽然并没有完全阐明这两者之间具体的联系,但是通过多年来临床大量病人的研究,从现象推断,很多糖尿病患者相比于一般人群而言更容易发生痴呆

   目前认为糖尿病同痴呆有一定的联系,虽然并没有完全阐明这两者之间具体的联系,但是通过多年来临床大量病人的研究,从现象推断,很多糖尿病患者相比于一般人群而言更容易发生痴呆,这是因为痴呆作为一种神经系统的疾病,同血管、神经肯定是直接相关的。而糖尿病患者的并发症当中,有很大的部分就属于神经系统的并发症,包括糖尿病神经病变、糖尿病脑血管病变等,这些病变在一定程度上对痴呆的形成、发展都起到一定的作用,这是因为糖尿病患者在血管、神经功能发生紊乱的情况下,整个神经细胞的活性和新陈代谢都会受到影响,而这往往就是痴呆的基础

   接下来我们一起来看看这篇有关糖尿病与痴呆的临床研究吧。

   目的随着1型糖尿病患者的预期寿命有所增加,尚不清楚血糖控制水平对于维持晚年大脑健康的作用。我们调查了老年1型糖尿病患者长期血糖控制与痴呆的关系。

   方法我们从1996年至2015年跟踪随访了3433名年龄在50岁以上的1型糖尿病患者。从就诊记录中确定了糖化血红蛋白(HbA1c),痴呆诊断和其他合并症。Cox比例风险模型用于评估血糖波动痴呆的关系,并调整年龄,性别,种族民族,基线健康状况和HbA1c测量频率。

   结果平均随访6.3年,155例(4.5%)1型糖尿病患者被诊断为痴呆。≥50%的HbA1c测量值在8-8.9%(64-74mmol/mol)和9%(75mmol/mol)的患者中,痴呆风险分别增加了65%和79%。相比之下,那些测量值<50%的患者(HbA1c 8-8.9%调整风险比[aHR] 1.65 [95% CI 1.06, 2.57],HbA1c 9% aHR 1.79 [95% CI 1.11, 2.90])。相比之下,在6-6.9% (42-52 mmol/mol)和7-7.9% (53-63 mmol/mol)的HbA1caHR为0.55 (95% CI 0.34, 0.88)和0.55 (95% CI 0.37, 0.82)的患者患痴呆的风险降低了45%。

表 HbA1c分层的患痴呆风险
*在模型中调整以下基线健康状况:卒中史、心肌梗死、肾病、神经病变、严重糖尿病视网膜病变、外周动脉疾病、高血糖事件和低血糖事件。
 

结 论在老年1型糖尿病患者中,大部分暴露于HbA1c 8-8.9%和≥9%的患者痴呆风险增加,而大多数暴露于HbA1c6-6.9%和7-7.9%的患者痴呆风险降低。因此认为老年1型糖尿病患者的血糖控制水平与大脑衰老相一致。

原始出处:

Mary E. Lacy,Paola Gilsanz,Andrew J. Karter,et al.Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes.Diabetes Care 2018 11;41(11) 

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    2021-09-03 14693e10m22暂无昵称

    👍🏻

    0

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    2021-09-02 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2021-09-02 junJUN

    老年人痴呆何药可用??

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