研究发现,高血糖不仅与糖尿病,也与老年痴呆症风险有关

High blood sugar, not just diabetes, linked to dementia risk, study finds

 

 

 


 
研究人员称,血糖水平升高,而不仅仅是糖尿病,可能会引发痴呆症。美联社
一项重要的新研究发现,较高的血糖水平,即使是那些远低于糖尿病的人,似乎也会增加患痴呆症的风险。研究人员称,这项研究提出了一种新的预防阿尔茨海默氏症的方法——将葡萄糖维持在健康水平。
 
阿尔茨海默氏症是迄今为止最常见的痴呆症,人们早就知道,糖尿病使其更有可能发生。这项新的研究追踪了各种人群的血糖,包括糖尿病患者和非糖尿病患者,观察血糖如何影响患这种精神疾病的风险。
 
这项研究的负责人、西雅图华盛顿大学的保罗·克兰博士说,这项研究结果挑战了目前的观点,因为它表明,引起人们关注的不仅仅是糖尿病的高糖水平。
 
美国国家老龄化研究所(National Institute on Aging)的科学家达拉斯•安德森(Dallas Anderson)表示:“这是一种很好的、干净的模式。”
 
他说:“这是更大范围内的一部分”,并补充了证据表明,锻炼和控制血压、血糖和胆固醇是一种有效的延缓或预防痴呆症的方法。
 
因为许多开发有效药物的尝试都失败了,“目前看来,这是我们最好的选择,”安德森说。“我们必须做点什么。如果我们什么都不做,一直等到有了某种鸡尾酒药丸,我们可能要等很长时间。
 
全世界大约有3500万人患有痴呆症;在美国,大约有500万人患有老年痴呆症。原因尚不清楚。目前的治疗只是暂时缓解症状。患有糖尿病的人不能制造足够的胰岛素,或者他们的身体不能很好地利用胰岛素将食物转化为能量。研究人员说,这会导致血液中的糖分升高,从而损害肾脏和其他器官——可能是大脑。
 
这项新研究发表在周四的《新英格兰医学杂志》(new England Journal of Medicine)上,它只是对人们进行了跟踪调查,没有测试降低血糖是否有助于治疗或预防痴呆症。克兰说,这需要在一项新的研究中进行测试,人们不会做平常不会做的检测。
 
他说:“从这样的研究中,我们不知道降低血糖水平是否会预防或以某种方式改变痴呆症,”但避免患上糖尿病总是一个好主意。
 
健康饮食,运动和控制体重都有助于血糖控制。
 
这项研究涉及了西雅图地区医疗保健系统健康合作社(Group Health Cooperative)的2067名65岁以上的老人。一开始,232名参与者患有糖尿病;其余的没有。在研究开始后的几年里,他们每人至少做了五次血糖测试,在研究开始后又做了更多。研究人员对这些水平进行了平均计算,以平衡一天中、饭前或饭后不同时间的测试结果。
 
参与者每两年接受一次标准的思考能力测试,并被问及吸烟、锻炼和其他影响痴呆症风险的因素。

 


 
经过近7年的跟踪调查,其中524人(或四分之一)患上了痴呆症——主要是阿尔茨海默氏症。在一开始没有糖尿病的参与者中,在过去五年中血糖水平较高的人比血糖水平较低的人患痴呆症的风险高18%。
 
在一开始患有糖尿病的参与者中,血糖较高的人比血糖较低的人患痴呆症的可能性高出40%。
 


即使研究人员考虑了参与者是否携带apoE4基因,血糖对痴呆症风险的影响也被观察到,而apoE4基因会增加患老年痴呆症的风险。
 
克兰说,至少对于糖尿病患者来说,研究结果表明,良好的血糖控制对认知能力很重要。
 
对于那些没有糖尿病的人来说,“这可能是大脑的问题,你每多摄入一点血糖就会有更高的风险,”他说。“它改变了我们对阈值(临界值)的看法,改变了我们对什么是正常的、什么是不正常的看法。”

 

 

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High blood sugar, not just diabetes, linked to dementia risk, study finds

 

Elevated blood sugar levels, and not just diabetes, could be a risk for dementia, researchers say. Associated Press

Higher blood-sugar levels, even those well short of diabetes, seem to raise the risk of developing dementia, a major new study finds. Researchers say it suggests a novel way to try to prevent Alzheimer's disease — by keeping glucose at a healthy level.

 

Alzheimer's is by far the most common form of dementia and it's long been known that diabetes makes it more likely. The new study tracked blood sugar over time in all sorts of people — with and without diabetes — to see how it affects risk for the mind-robbing disease.

 

The results challenge current thinking by showing that it's not just the high glucose levels of diabetes that are a concern, said the study's leader, Dr. Paul Crane of the University of Washington in Seattle.

 

"It's a nice, clean pattern" — risk rises as blood sugar does, said Dallas Anderson, a scientist at the National Institute on Aging, the federal agency that paid for the study.

 

"This is part of a larger picture" and adds evidence that exercising and controlling blood pressure, blood sugar and cholesterol are a viable way to delay or prevent dementia, he said.

 

Because so many attempts to develop effective drugs have failed, "It looks like, at the moment, sort of our best bet," Anderson said. "We have to do something. If we just do nothing and wait around till there's some kind of cocktail of pills, we could be waiting a long time."

 

About 35 million people worldwide have dementia; in the United States, about 5 million have Alzheimer's disease. What causes it isn't known. Current treatments just temporarily ease symptoms. People who have diabetes don't make enough insulin, or their bodies don't use insulin well, to turn food into energy. That causes sugar in the blood to rise, which can damage the kidneys and other organs — possibly the brain, researchers say.

 

The new study, published in Thursday's New England Journal of Medicine, just tracked people and did not test whether lowering someone's blood sugar would help treat or prevent dementia. That would have to be tested in a new study, and people should not seek blood-sugar tests they wouldn't normally get otherwise, Crane said.

 

"We don't know from a study like this whether bringing down the glucose level will prevent or somehow modify dementia," but it's always a good idea to avoid developing diabetes, he said.

 

Eating well, exercising and controlling weight all help to keep blood sugar in line.

 

The study involved 2,067 people 65 and older in the Group Health Cooperative, a Seattle-area health care system. At the start, 232 participants had diabetes; the rest did not. They each had at least five blood-sugar tests within a few years of starting the study and more after it was underway. Researchers averaged these levels over time to even out spikes and dips from testing at various times of day or before or after a meal.

 

Participants were given standard tests for thinking skills every two years and asked about smoking, exercise and other things that affect dementia risk.

 

After nearly seven years of follow-up, 524, or one quarter of them, had developed dementia — mostly Alzheimer's disease. Among participants who started out without diabetes, those with higher glucose levels over the previous five years had an 18 percent greater risk of developing dementia than those with lower glucose levels.

 

Among participants with diabetes at the outset, those with higher blood sugar were 40 percent more likely to develop dementia than diabetics at the lower end of the glucose spectrum.

 

The effect of blood sugar on dementia risk was seen even when researchers took into account whether participants had the apoE4 gene, which raises the risk for Alzheimer's.

 

At least for diabetics, the results suggest that good blood-sugar control is important for cognition, Crane said.

 

For those without diabetes, "it may be that with the brain, every additional bit of blood sugar that you have is associated with higher risk," he said. "It changes how we think about thresholds, how we think about what is normal, what is abnormal."

https://www.nbcnews.com/healthmain/high-blood-sugar-not-just-diabetes-linked-dementia-risk-study-6C10871619