在2型糖尿病中使用胰岛素和痴呆风险:基于人口的比较队列研究
Wajd Alkabbani1, Colleen J Maxwell1,2, Ruth Ann Marrie3
1School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada.
Diabetes care
|June 14, 2023
概括
在2型糖尿病中使用胰岛素不会增加痴呆症的风险,当注意管理混因素时. 在调整了疾病严重程度和其他指标后,这项研究没有发现任何显著的关联.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 以前的研究表明,胰岛素使用与2型糖尿病患者痴呆风险增加之间存在联系.
- 这种关联可能因指示和疾病严重程度而混,需要进一步调查.
研究的目的:
- 重新评估胰岛素使用与2型糖尿病痴呆风险之间的关联.
- 通过使用可靠的研究设计和统计方法来考虑根据指示和疾病严重程度的混.
主要方法:
- 一项使用来自不列颠哥伦比亚省 (1998-2016) 的行政卫生数据进行的比较队列研究.
- 包括新使用胰岛素与非胰岛素抗高血糖药物的新用户,来自受限队列,先前接触过两个非胰岛素类别.
- 用多变量分析和治疗权重的逆概率 (IPTW) 来调整混.
主要成果:
- 研究队列包括7,863名胰岛素使用者和25,230名非胰岛素使用者.
- 最初的分析显示,胰岛素的痴呆风险较高 (HR 1.68),在多变量调整后降低 (HR 1.39).
- 在IPTW之后,这种关联不再显著 (HR 1.14).
结论:
- 在之前用两种非胰岛素抗高血糖药物治疗的2型糖尿病患者中,胰岛素使用和全因性痴呆之间没有发现显著的关联.
- 在评估与胰岛素治疗相关的痴呆风险时,仔细调整混因素至关重要.
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