PDF(Pubmed)
Abstract：
To determine whether antihypertensive medication (AHM) acting through the renin angiotensin system (RAS-AHM), compared with other AHM, can mitigate effects on cognitive function and risk for impairment in a population with type 2 diabetes mellitus (T2DM).
This secondary analysis of the randomized controlled Action for Health in Diabetes (Look AHEAD) study included 712 community-dwelling participants who were followed over 15 years. Logistic regression was used to relate RAS-AHM use to cognitive impairment, and linear regression was used to relate RAS-AHM use to domain-specific cognitive function after adjusting for potential confounders.
A total of 563 individuals reported RAS-AHM use and 149 reported other-AHM use during the study. RAS-AHM users have college or higher education (53%), had higher baseline glycated haemoglobin (57 mmol/mol), and reported higher diabetes medication use (86%), while other-AHM users were more likely to be White (72%), obese (25%) and to have cardiovascular history (19%). RAS-AHM use was not associated with a reduced risk of dementia compared with other-AHM use. We did observe better executive function (Trail Making Test, part B, P < 0.04), processing speed (Digit Symbol Substitution Test, P < 0.004), verbal memory (Rey Auditory Verbal Learning Test-delayed recall, P < 0.005), and composite score (P < 0.008) among RAS-AHM users compared with other-AHM users.
In this sample of adults with T2DM, free of dementia at baseline, we observed a slower decline in processing speed, executive function, verbal memory, and composite score among RAS-AHM users.
This secondary analysis of the randomized controlled Action for Health in Diabetes (Look AHEAD) study included 712 community-dwelling participants who were followed over 15 years. Logistic regression was used to relate RAS-AHM use to cognitive impairment, and linear regression was used to relate RAS-AHM use to domain-specific cognitive function after adjusting for potential confounders.
A total of 563 individuals reported RAS-AHM use and 149 reported other-AHM use during the study. RAS-AHM users have college or higher education (53%), had higher baseline glycated haemoglobin (57 mmol/mol), and reported higher diabetes medication use (86%), while other-AHM users were more likely to be White (72%), obese (25%) and to have cardiovascular history (19%). RAS-AHM use was not associated with a reduced risk of dementia compared with other-AHM use. We did observe better executive function (Trail Making Test, part B, P < 0.04), processing speed (Digit Symbol Substitution Test, P < 0.004), verbal memory (Rey Auditory Verbal Learning Test-delayed recall, P < 0.005), and composite score (P < 0.008) among RAS-AHM users compared with other-AHM users.
In this sample of adults with T2DM, free of dementia at baseline, we observed a slower decline in processing speed, executive function, verbal memory, and composite score among RAS-AHM users.
摘要：
确定抗高血压药物（AHM）是否通过肾素血管紧张素系统（RAS-AHM）起作用，与其他AHM相比，可以减轻对2型糖尿病（T2DM）人群认知功能的影响和受损风险。
这项对糖尿病健康随机对照行动（LookAHEAD）研究的二次分析包括712名社区居住的参与者，他们被随访了15年。Logistic回归用于将RAS-AHM的使用与认知障碍联系起来，在调整潜在的混杂因素后,使用线性回归将RAS-AHM的使用与特定领域的认知功能相关联.
在研究期间，共有563人报告使用RAS-AHM，149人报告使用其他AHM。RAS-AHM用户受过大学或高等教育(53%)，基线糖化血红蛋白较高（57mmol/mol），并报告了更高的糖尿病药物使用率（86％），而其他AHM用户更有可能是白人(72%)，肥胖（25%）和有心血管病史（19%）。与其他AHM使用相比，RAS-AHM使用与痴呆风险降低无关。我们确实观察到了更好的执行功能(跟踪测试，B部分,P<0.04),处理速度(数字符号替换测试，P<0.004),言语记忆(Rey听觉言语学习测试-延迟回忆，P<0.005)，与其他AHM用户相比，RAS-AHM用户的综合得分（P<0.008）。
在这个2型糖尿病成人样本中，基线时没有痴呆，我们观察到处理速度下降较慢，执行功能，口头记忆,RAS-AHM用户之间的综合得分。
这项对糖尿病健康随机对照行动（LookAHEAD）研究的二次分析包括712名社区居住的参与者，他们被随访了15年。Logistic回归用于将RAS-AHM的使用与认知障碍联系起来，在调整潜在的混杂因素后,使用线性回归将RAS-AHM的使用与特定领域的认知功能相关联.
在研究期间，共有563人报告使用RAS-AHM，149人报告使用其他AHM。RAS-AHM用户受过大学或高等教育(53%)，基线糖化血红蛋白较高（57mmol/mol），并报告了更高的糖尿病药物使用率（86％），而其他AHM用户更有可能是白人(72%)，肥胖（25%）和有心血管病史（19%）。与其他AHM使用相比，RAS-AHM使用与痴呆风险降低无关。我们确实观察到了更好的执行功能(跟踪测试，B部分,P<0.04),处理速度(数字符号替换测试，P<0.004),言语记忆(Rey听觉言语学习测试-延迟回忆，P<0.005)，与其他AHM用户相比，RAS-AHM用户的综合得分（P<0.008）。
在这个2型糖尿病成人样本中，基线时没有痴呆，我们观察到处理速度下降较慢，执行功能，口头记忆,RAS-AHM用户之间的综合得分。
