To investigate the risk of incident dementia according to fasting glucose levels and presence of comorbidities.

Using a health insurance claims database and the results of biennial health examinations in South Korea, we selected 8,400,950 subjects aged ≥40 years who underwent health examinations in 2009–2010. We followed them until 2016. Subjects’ baseline characteristics were categorized by presence of diabetes (yes/no) and glycemic status as normoglycemia, impaired fasting glucose (IFG), new-onset diabetes, or known diabetes (duration <5 years or ≥5 years). We estimated adjusted hazard ratios (aHRs) for dementia occurrence in each category.

During the observation period of 48,323,729 person-years, all-cause dementia developed in 353,392 subjects (4.2%). Compared with normoglycemia, aHRs (95% CI) were 1.01 (1.01–1.02) in IFG, 1.45 (1.44–1.47) in new-onset diabetes, 1.32 (1.30–1.33) in known diabetes <5 years, and 1.62 (1.60–1.64) in known diabetes ≥5 years. We found that associations between ischemic heart disease and chronic kidney disease with incident dementia were affected by the presence of diabetes. Ischemic stroke showed a greater association with incident dementia than diabetes.

Mild degrees of hyperglycemia and presence of comorbidities were associated with incident dementia. Intervention during the prodromal stage of a chronic disease (e.g., prediabetes) could be considered for dementia prevention.

根据空腹血糖水平和合并症的存在来调查痴呆症的风险。

使用健康保险索赔数据库和韩国两年一次的健康检查结果，我们选择了 2009-2010 年接受健康检查的 8,400,950 名年龄≥40 岁的受试者。我们一直跟踪他们直到 2016 年。受试者的基线特征按是否存在糖尿病（是/否）和血糖状态分类为血糖正常、空腹血糖受损 (IFG)、新发糖尿病或已知糖尿病（病程 <5 年或≥5 年）年）。我们估计了每个类别中痴呆发生的调整风险比（aHRs）。

在 48,323,729 人年的观察期内，353,392 名受试者（4.2%）出现全因痴呆。与正常血糖相比，IFG 的 aHR (95% CI) 为 1.01 (1.01–1.02)，新发糖尿病为 1.45 (1.44–1.47)，已知糖尿病 <5 岁为 1.32 (1.30–1.33)，1.62 (1.60– 1.64）已知糖尿病≥5年。我们发现缺血性心脏病和慢性肾病与痴呆症之间的关联受到糖尿病的影响。与糖尿病相比，缺血性中风与痴呆的相关性更大。

轻度高血糖和合并症与痴呆症的发生有关。可以考虑在慢性疾病（例如前驱糖尿病）的前驱阶段进行干预以预防痴呆。