Microvascular burden and long-term risk of stroke and dementia in type 2 diabetes mellitus

Liu，Yu Jie1; Zhao，Jun Yu2; Han，Wen Wen1; Yang，Huan Huan3; Wu，Xian Bo4; Xie，Fei5; Wang，Hai Peng5; Wang，Juan6; Zhao，Xin5; Wan，Zhong Xiao1; Chen，Guo Chong1; Qin，Li Qiang1,6; Li，Fu Rong4,7,8

2024-06-01

10.1016/j.jad.2024.03.053

Journal of Affective Disorders   影响因子和分区

0165-0327

1573-2517

Objective: To examine the associations between microvascular disease (MVD) and risk of stroke, dementia, and their major subtypes among individuals with type 2 diabetes mellitus (T2DM). Methods: We included 26,173 participants with T2DM from the UK Biobank who had no known stroke or dementia at baseline. MVD burden was reflected by the presence of retinopathy, peripheral neuropathy, and chronic kidney disease. Cox regression models were used to estimate hazard ratios (HRs) and 95 % confidential intervals (CIs) of stroke and dementia associated with overall MVD burden and individual MVD. Results: During a median follow-up of 11.5 years, 1103 incident stroke (964 ischemic and 269 hemorrhagic stroke) and 813 incident dementia (312 Alzheimer's disease and 304 vascular dementia) cases were identified. The risk of stroke, dementia, and their major subtypes all increased with an increasing number of MVD (all P-trend <0.001). The adjusted HRs (95 % CIs) comparing three with no MVD were 5.03 (3.16, 8.02) for all stroke, 4.57 (2.75, 7.59) for ischemic stroke, and 6.60 (2.65, 16.43) for hemorrhagic stroke. The corresponding estimates were 4.28 (2.33, 7.86) for all-cause dementia, 6.96 (3.02, 16.01) for Alzheimer's disease, and 3.81 (1.40, 10.42) for vascular dementia. Among the three MVD, chronic kidney disease showed the strongest associations with both stroke subtypes, while peripheral neuropathy was most strongly associated with both dementia subtypes. Conclusions: Risk of stroke, dementia, and their major subtypes increased with an increasing number of MVD. The associations of individual MVD with stroke and dementia varied substantially by types of MVD.

Chronic kidney disease Diabetic retinopathy Microvascular complications Peripheral neuropathy Type 2 diabetes mellitus

SCI ; SSCI

英语

其他

PSYCHIATRY/PSYCHOLOGY

2-s2.0-85187938093

Scopus

1.Department of Nutrition and Food Hygiene,MOE Key Laboratory of Geriatric Diseases and Immunology,School of Public Health,Suzhou Medical College of Soochow University,Suzhou,China
2.School of Medicine,Jiangsu University,Zhenjiang,China
3.Vanke School of Public Health,Tsinghua University,Beijing,China
4.Department of Epidemiology,School of Public Health,Southern Medical University,Guangzhou,China
5.Department of Cardiology,The First Affiliated Hospital of Soochow University,Suzhou,China
6.Changzhou Geriatric Hospital affiliated to Soochow University,Changzhou,China
7.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
8.Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine,Shenzhen,China

Liu，Yu Jie,Zhao，Jun Yu,Han，Wen Wen,et al. Microvascular burden and long-term risk of stroke and dementia in type 2 diabetes mellitus[J]. Journal of Affective Disorders,2024,354:68-74.

Liu，Yu Jie.,Zhao，Jun Yu.,Han，Wen Wen.,Yang，Huan Huan.,Wu，Xian Bo.,...&Li，Fu Rong.(2024).Microvascular burden and long-term risk of stroke and dementia in type 2 diabetes mellitus.Journal of Affective Disorders,354,68-74.

Liu，Yu Jie,et al."Microvascular burden and long-term risk of stroke and dementia in type 2 diabetes mellitus".Journal of Affective Disorders 354(2024):68-74.