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Different glycaemia‐related risk factors for incident Alzheimer's disease in men and women with type 2 diabetes—A sex‐specific analysis of the Hong Kong diabetes database
Author(s) -
Lee ChiHo,
Lui David T. W.,
Cheung Chloe Y. Y.,
Woo YuCho,
Fong Carol H. Y.,
Yuen Michele M. A.,
Shea YatFung,
Siu David C. W.,
Chan KoonHo,
Chow WingSun,
Lam Karen S. L.
Publication year - 2021
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3401
Subject(s) - medicine , diabetes mellitus , type 2 diabetes , body mass index , incidence (geometry) , epidemiology , cohort , disease , cohort study , proportional hazards model , demography , gerontology , endocrinology , physics , sociology , optics
Abstract Aims Sexual dimorphism has been reported in the epidemiology, neurobiologic susceptibility and clinical presentation of Alzheimer's disease (AD). As poor glycaemic control is associated with increased risks of AD, we aimed to investigate whether glycaemia‐related risk factors also differ between men and women, using a retrospective, sex‐specific analysis of a large Chinese cohort with diabetes. Materials & Methods A total of 85,514 Chinese individuals with type 2 diabetes (T2D; 46,783 women and 38,731 men), aged ≥60 years, were identified from electronic health records and observed for incident AD. Multivariable Cox regression analysis was used to evaluate the associations with incident AD of several glycaemia‐related risk factors, including severe hypoglycaemia, mean HbA1c and indices of HbA1c variability, in men and women separately. Results Over a median follow‐up of 6 years, women had a higher incidence of AD than men (2.3% vs. 1.2%, p < 0.001). Both men and women shared the same independent non‐glycaemic clinical predictors, which included older age, lower body mass index and longer duration of diabetes. However, for glycaemia‐related risk factors, we observed that severe hypoglycaemia and indices of HbA1c variability were independent predictors of incident AD in women but not in men, and the associations were irrespective of their baseline glycaemic control and duration of diabetes. Conclusions Our findings highlighted that glycaemia‐related risk factors for incident AD differ between men and women with T2D. Strategies to maintain glycaemic stability and avoid severe hypoglycaemia might be especially important to preserve healthy cognition in older women with diabetes.