在新使用甲福明的患者中,早期血糖控制和随后发生痴呆症的风险
Melinda C Power1, Morten Madsen2, Katrine Bødkergaard2
1Department of Epidemiology, George Washington University, Milken Institute School of Public Health, Washington, DC, USA.
The American journal of medicine
|November 6, 2025
概括
在2型糖尿病患者中,糖化血红蛋白 (HbA1c) 在7%以下的水平,开始服用甲福林,与痴呆症风险降低有关. 较严格的血糖控制在6.5%以下没有显示出额外的痴呆症预防益处.
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:
- 患有糖尿病的人面临患痴呆症的风险更高.
- 在开始单独治疗甲福明的患者中,预防痴呆症的最佳血糖控制目标尚不清楚.
研究的目的:
- 为了研究早期血糖控制和痴呆症风险之间的关系,在开始甲福明单一治疗的个体中.
- 确定最佳的血红蛋白A1c (HbA1c) 目标,以减少痴呆风险.
主要方法:
- 利用了2000-2018年丹麦卫生登记处的数据,分析了50岁以上的甲福明单一疗法发起者.
- 采用基于标准危险和倾向分数的模型来评估早期血糖控制和发病性痴呆之间的关联.
- 根据年龄,日历年份和心血管疾病状况探索子组影响.
主要成果:
- 在46332名患者中,83%的人在一年内达到HbA1c <7%. 当HbA1c水平>7%时,观察到痴呆症风险增加.
- 在实现HbA1c<7%和更严格的对照 (例如,<6.5%或<6%) 之间,在痴呆风险上发现了很小的差异.
- 血糖控制对痴呆风险的好处似乎仅限于没有心血管疾病的人,并且在几年内表现出来.
结论:
- 支持目前针对2型糖尿病早期血糖控制 (HbA1c <7%) 的建议,以减少痴呆风险.
- 提供证据表明,追求非常严格的血糖控制 (HbA1c <6.5%或<6%) 没有提供额外的痴呆症预防益处.
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