Severe Hypoglycemia Increases Dementia Risk and Related Mortality: A Nationwide, Population-based Cohort Study

被引:23
|
作者
Han, Eugene [1 ]
Han, Kyung-do [2 ]
Lee, Byung-Wan [3 ,4 ]
Kang, Eun Seok [3 ,4 ]
Cha, Bong-Soo [3 ,4 ]
Ko, Seung-Hyun [5 ]
Lee, Yong-Ho [3 ,4 ,6 ]
机构
[1] Keimyung Univ, Dept Internal Med, Sch Med, Daegu 42601, South Korea
[2] Soongsil Univ, Dept Stat & Actuarial Sci, Seoul 06978, South Korea
[3] Yonsei Univ, Inst Endocrine Res, Coll Med, Seoul 03722, South Korea
[4] Yonsei Univ, Dept Internal Med, Div Endocrinol, Coll Med, 50-1 Yonsei Ro, Seoul 03722, South Korea
[5] Catholic Univ, Coll Med, Dept Internal Med, Div Endocrinol & Metab, Seoul 16247, South Korea
[6] Yonsei Univ, Glycosylat Network Res Ctr, Dept Syst Biol, Seoul 03772, South Korea
来源
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2022年 / 107卷 / 05期
关键词
hypoglycemia; dementia; mortality; diabetes; INSULIN-INDUCED HYPOGLYCEMIA; TYPE-2; DIABETES-MELLITUS; COGNITIVE IMPAIRMENT; ALZHEIMERS-DISEASE; ASSOCIATION; RESISTANCE; ADULTS; PREVALENCE; RESPONSES;
D O I
10.1210/clinem/dgab860
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context There are few studies focused on the relationship between hypoglycemia and new-onset dementia in patients with type 2 diabetes and no study regarding mortality of dementia after hypoglycemia. Objective We investigated the effect of severe hypoglycemia on dementia subtypes and its relation to overall mortality in patients with type 2 diabetes. Methods We evaluated incident dementia, including Alzheimer disease and vascular dementia, among health checkup participants aged 40 years or older in the National Health Insurance System in Korea from January 2009 to December 2015. Episodes of severe hypoglycemia were examined for 3 years before the date of the health checkup. Results Among 2 032 689 participants (1 172 271 men, 860 418 women), 14 443 (0.7%) experienced severe hypoglycemia, during a mean follow-up period of 6.9 +/- 1.7 years. Individuals in the severe hypoglycemia group were more likely to be diagnosed with dementia compared to individuals without severe hypoglycemia (23.3% vs 7.3%; P < .001) and the overall incidence of Alzheimer disease was higher than vascular dementia. Dementia risk rose with increasing number of severe hypoglycemic episodes (1 episode [hazard ratio (HR) = 1.54; 95% CI, 1.48-1.60], 2 or more episodes [HR = 1.80; 95% CI, 1.66-1.94]). Overall mortality was higher in participants with dementia, but without severe hypoglycemia (HR = 2.03; 95% CI, 1.96-2.10) and severe hypoglycemia, but without dementia (HR = 4.24; 95% CI, 4.29-4.40), and risk of death was highest in those with both severe hypoglycemia and dementia (HR = 5.08; 95% CI, 4.83-5.35). Conclusion Severe hypoglycemia is associated with dementia, especially Alzheimer disease and mortality; together, they have an additive effect on overall mortality.
引用
收藏
页码:E1976 / E1986
页数:11
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