Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study
Background We investigated whether fasting glucose (FG) variability could predict the risk of dementia. Methods This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which include...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2022-11-01
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| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | http://e-dmj.org/upload/pdf/dmj-2021-0346.pdf |
| _version_ | 1811321479223050240 |
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| author | Da Young Lee Jaeyoung Kim Sanghyun Park So Young Park Ji Hee Yu Ji A Seo Nam Hoon Kim Hye Jin Yoo Sin Gon Kim Kyung Mook Choi Sei Hyun Baik Kyungdo Han Nan Hee Kim |
| author_facet | Da Young Lee Jaeyoung Kim Sanghyun Park So Young Park Ji Hee Yu Ji A Seo Nam Hoon Kim Hye Jin Yoo Sin Gon Kim Kyung Mook Choi Sei Hyun Baik Kyungdo Han Nan Hee Kim |
| author_sort | Da Young Lee |
| collection | DOAJ |
| description | Background We investigated whether fasting glucose (FG) variability could predict the risk of dementia. Methods This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which included at least one examination between 2009 and 2010. A total of 769,554 individuals were included, excluding those aged <40 years and those with dementia. FG variability was measured using the variability independent of the mean (FG-VIM). The incidence of dementia was defined by the International Classification of Diseases 10th Revision codes and prescription of anti-dementia medication and was subdivided into Alzheimer’s disease (AD) and vascular dementia (VD). Results During the 6.9-year follow-up, 54,837, 41,032, and 6,892 cases of all-cause dementia, AD, and VD, respectively, were identified. Cox proportional regression analyses showed that as the FG-VIM quartile increased, the risk of dementia serially increased after adjustment for metabolic factors, income status, and diabetes-related characteristics, including the mean FG. Participants in FG-VIM quartile 4 showed a 18%, 19%, and 17% higher risk for all-cause dementia, AD, and VD, respectively, than those in quartile 1; this particularly included non-obese patients with a longer duration of diabetes, high FG levels, dyslipidemia, and those taking glucose-lowering medications. Conversely, the baseline FG status and dementia showed a U-shaped association. Conclusion Increased FG variability over 5 years can predict the risk of dementia in individuals with diabetes in Korea. This finding was more pronounced in patients with less favorable metabolic profiles. |
| first_indexed | 2024-04-13T13:18:30Z |
| format | Article |
| id | doaj.art-77ffd6697cd243fba8aa3c02ea00c94e |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-04-13T13:18:30Z |
| publishDate | 2022-11-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-77ffd6697cd243fba8aa3c02ea00c94e2022-12-22T02:45:24ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872022-11-0146692393510.4093/dmj.2021.03462671Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort StudyDa Young Lee0Jaeyoung Kim1Sanghyun Park2So Young Park3Ji Hee Yu4Ji A Seo5Nam Hoon Kim6Hye Jin Yoo7Sin Gon Kim8Kyung Mook Choi9Sei Hyun Baik10Kyungdo Han11Nan Hee Kim12 Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Research Institute for Skin Image, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, KoreaBackground We investigated whether fasting glucose (FG) variability could predict the risk of dementia. Methods This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which included at least one examination between 2009 and 2010. A total of 769,554 individuals were included, excluding those aged <40 years and those with dementia. FG variability was measured using the variability independent of the mean (FG-VIM). The incidence of dementia was defined by the International Classification of Diseases 10th Revision codes and prescription of anti-dementia medication and was subdivided into Alzheimer’s disease (AD) and vascular dementia (VD). Results During the 6.9-year follow-up, 54,837, 41,032, and 6,892 cases of all-cause dementia, AD, and VD, respectively, were identified. Cox proportional regression analyses showed that as the FG-VIM quartile increased, the risk of dementia serially increased after adjustment for metabolic factors, income status, and diabetes-related characteristics, including the mean FG. Participants in FG-VIM quartile 4 showed a 18%, 19%, and 17% higher risk for all-cause dementia, AD, and VD, respectively, than those in quartile 1; this particularly included non-obese patients with a longer duration of diabetes, high FG levels, dyslipidemia, and those taking glucose-lowering medications. Conversely, the baseline FG status and dementia showed a U-shaped association. Conclusion Increased FG variability over 5 years can predict the risk of dementia in individuals with diabetes in Korea. This finding was more pronounced in patients with less favorable metabolic profiles.http://e-dmj.org/upload/pdf/dmj-2021-0346.pdfalzheimer diseasedementiadementia, vasculardiabetes mellitusglucose |
| spellingShingle | Da Young Lee Jaeyoung Kim Sanghyun Park So Young Park Ji Hee Yu Ji A Seo Nam Hoon Kim Hye Jin Yoo Sin Gon Kim Kyung Mook Choi Sei Hyun Baik Kyungdo Han Nan Hee Kim Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study Diabetes & Metabolism Journal alzheimer disease dementia dementia, vascular diabetes mellitus glucose |
| title | Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study |
| title_full | Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study |
| title_fullStr | Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study |
| title_full_unstemmed | Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study |
| title_short | Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study |
| title_sort | fasting glucose variability and the risk of dementia in individuals with diabetes a nationwide cohort study |
| topic | alzheimer disease dementia dementia, vascular diabetes mellitus glucose |
| url | http://e-dmj.org/upload/pdf/dmj-2021-0346.pdf |
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