Endocrine · 2025
Association of peripheral neuropathy with dementia in type 2 diabetes: a 5-year follow-up study using the national health insurance service-national health information database.
СтатьяНазвание и аннотация: Перевод в очереди
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Jin Heung Yong, Kim Ko Woon, Lee Kyung Ae, Park Tae Sun, Kim Min Ji, Kim Jong Seung
Аннотация
OBJECTIVE: To investigate whether the incidence of dementia is associated with diabetic peripheral neuropathy (DPN) in type 2 diabetes.
METHODS: Using the National Health Insurance Service-National Health Information Database, we calculated the incidence of various types of dementia according to type 2 diabetes with or without DPN by applying multivariate Cox regression analysis. Propensity score matching was performed to equalize each group by considering demographic characteristics and underlying conditions.
RESULTS: The incidence of various types of dementia was higher in patients with type 2 diabetes than in those without diabetes. The risk of developing dementia was higher in type 2 diabetes with DPN than in type 2 diabetes without DPN, irrespective of dementia type (all dementia: 1.53 vs. 2.1 vs. 1.4, P < 0.05, Alzheimer's disease: 1.46 vs. 1.98 vs. 1.34, P < 0.05, vascular dementia: 1.86 vs. 2.75 vs. 1.66, P < 0.05, other dementia: 1.62 vs. 2.19 vs. 1.48, P < 0.05; all type 2 diabetes vs. type 2 diabetes with DPN vs. type 2 diabetes without DPN compared with non-diabetes). When sodium-glucose cotransporter-2 inhibitors (SGLT2Is) were used, the incidence of all dementia types was lower in patients with type 2 diabetes than in patients with type 2 diabetes who did not use SGLT2Is although the incidence showed more decreased trend when dipeptidyl peptidase IV inhibitor (DPPIVI) was combined (all dementia: 0.51-0.71, P < 0.05, Alzheimer's disease: 0.78-0.80, P < 0.05, vascular dementia: 0.28-0.35, P < 0.05, other dementia: 0.2-0.70, P < 0.05; SGLT2Is user vs. neither SGLT2I nor DPPIVI). This pattern was also observed in patients with type 2 diabetes and DPN (all dementia: 0.32-0.56, P < 0.05, Alzheimer's disease: 0.44-0.55, P < 0.05, vascular dementia: 0.33, P < 0.05, other dementia: 0.53, P < 0.05; SGLT2Is user vs. neither SGLT2I nor DPPIVI).
CONCLUSIONS: More active diagnostic and prevention efforts are needed to address the risk of developing all forms of dementia, including vascular dementia, in patients with diabetes and DPN.
METHODS: Using the National Health Insurance Service-National Health Information Database, we calculated the incidence of various types of dementia according to type 2 diabetes with or without DPN by applying multivariate Cox regression analysis. Propensity score matching was performed to equalize each group by considering demographic characteristics and underlying conditions.
RESULTS: The incidence of various types of dementia was higher in patients with type 2 diabetes than in those without diabetes. The risk of developing dementia was higher in type 2 diabetes with DPN than in type 2 diabetes without DPN, irrespective of dementia type (all dementia: 1.53 vs. 2.1 vs. 1.4, P < 0.05, Alzheimer's disease: 1.46 vs. 1.98 vs. 1.34, P < 0.05, vascular dementia: 1.86 vs. 2.75 vs. 1.66, P < 0.05, other dementia: 1.62 vs. 2.19 vs. 1.48, P < 0.05; all type 2 diabetes vs. type 2 diabetes with DPN vs. type 2 diabetes without DPN compared with non-diabetes). When sodium-glucose cotransporter-2 inhibitors (SGLT2Is) were used, the incidence of all dementia types was lower in patients with type 2 diabetes than in patients with type 2 diabetes who did not use SGLT2Is although the incidence showed more decreased trend when dipeptidyl peptidase IV inhibitor (DPPIVI) was combined (all dementia: 0.51-0.71, P < 0.05, Alzheimer's disease: 0.78-0.80, P < 0.05, vascular dementia: 0.28-0.35, P < 0.05, other dementia: 0.2-0.70, P < 0.05; SGLT2Is user vs. neither SGLT2I nor DPPIVI). This pattern was also observed in patients with type 2 diabetes and DPN (all dementia: 0.32-0.56, P < 0.05, Alzheimer's disease: 0.44-0.55, P < 0.05, vascular dementia: 0.33, P < 0.05, other dementia: 0.53, P < 0.05; SGLT2Is user vs. neither SGLT2I nor DPPIVI).
CONCLUSIONS: More active diagnostic and prevention efforts are needed to address the risk of developing all forms of dementia, including vascular dementia, in patients with diabetes and DPN.