アブストラクト | OBJECTIVES: To assess the association between sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use and the risk of incident dementia compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) use among individuals with type 2 diabetes. DESIGN: A population-based retrospective cohort study. SETTING: The Clinical Practice Research Datalink (CPRD) Aurum database from the UK. PARTICIPANTS: Individuals with type 2 diabetes, aged 40 years or older, newly prescribed SGLT-2i or DPP-4i on or after 2013-2021, registered in the CPRD Aurum database. MAIN OUTCOME MEASURE: The primary outcome was incident dementia, and the secondary outcome was incident mild cognitive impairment (MCI). Cox proportional hazard models were used to estimate the HR and corresponding 95% CI for the primary and secondary outcomes. Propensity score fine stratification weights were used to adjust for confounding. RESULTS: Among a cohort of 118 006 individuals, the incident rate (IR) of dementia was 0.56/1000 person-years over a median follow-up period of 1.54 years among SGLT-2i users compared with 2.67/1000 person-years in DPP-4i users, over a median follow-up period of 1.79 years. The adjusted HR for SGLT-2i use compared with DPP-4i use for dementia was 0.78 (95% CI 0.55 to 1.12), while for MCI was 0.86 (95% CI 0.80 to 0.92). The age-specific stratified analysis demonstrated the adjusted HR for SGLT-2i use compared with DPP-4i use for the risk of incident dementia among elderly, aged >/=65 years, was 0.50 (95% CI 0.31 to 0.80). CONCLUSION: Primary findings did not yield conclusive evidence to infer an association between SGLT-2i use and the risk of incident dementia. |
投稿者 | Abdullah, Zarin; Cui, Ying; Platt, Robert W; Renoux, Christel; Azoulay, Laurent; Xia, Chenjie; Yu, Oriana Hoi Yun |
組織名 | Department of Epidemiology, Biostatistics, and Occupational Health, McGill;University, Montreal, Quebec, Canada.;Lady Davis Institute for Medical Research Centre for Clinical Epidemiology,;Montreal, Quebec, Canada.;Epidemiology, Biostatistics, and Occupational Health, McGill University,;Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research,;Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec,;Canada.;Montreal, Quebec, Canada hoi.yu@mcgill.ca.;Department of Medicine, McGill University, Montreal, Quebec, Canada. |