在2型糖尿病中SGLT2i启动时的基线HbA1c和痴呆风险
Jiaqiang Zhang1,2, Yangyang Wang1, Zhongyuan Lu1,3
1Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, People's Hospital of Henan Academy of Innovations in Medical Science, Zhengzhou, China.
Diabetes, obesity & metabolism
|October 20, 2025
概括
在开始用-葡萄糖携运体-2抑制剂 (SGLT2i) 治疗时的基线HbA1c水平预测了2型糖尿病患者的痴呆风险. 早些时候启动SGLT2i,即使HbA1c较高,也可能提供更好的认知保护.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 2型糖尿病 (T2DM) 是痴呆症的一个重要风险因素.
- 为了获得认知效益,启动-葡萄糖共传输体-2 抑制剂 (SGLT2i) 的最佳时间尚未确定.
- 在SGLT2i启动时基线HbA1c对痴呆风险的预测作用尚不清楚.
研究的目的:
- 研究在开始SGLT2i治疗的T2DM患者中基线HbA1c水平和痴呆风险之间的关联.
- 为了确定更高的基线HbA1c是否会影响SGLT2i对认知功能的保护作用.
主要方法:
- 使用全球协作网络进行的回顾性队列研究.
- 包括2005-2025年间开始SGLT2i的成年T2DM患者,有456天的洗期.
- 用于根据基线HbA1c (<7.0%,7.0%-8.9%,≥9.0%) 来分层患者的倾向性得分匹配.
主要成果:
- 随着基线HbA1c水平较高,痴呆风险增加 (HR 1.32为7.0%-8.9%,HR 1.68为≥9.0%与<7.0%).
- 在倾向分数匹配后,关联仍然显著 (HR分别为1.08和1.28).
- 对血管痴呆症观察到的最强的关联,在敏感性分析中发现一致的结果.
结论:
- 在SGLT2i启动时的基线HbA1c是痴呆风险的预测指标.
- 早些时候开始SGLT2i治疗,即使HbA1c较高,也可能对认知保护至关重要.
- 早期使用SGLT2i可能为大脑,心脏和脏健康带来更广泛的益处.
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