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Dipeptidyl peptidase 4 inhibitors vs. metformin for new-onset dementia: a propensity score-matched cohort study

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单位： [1]Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China. [2]Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China. [3]Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. [4]Children's Hospital of Fudan University, Shanghai, China. [5]Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China. [6]Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China. [7]Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. [8]Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. [9]Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [10]Department of Nephrology, the First People's Hospital of Foshan, Foshan, Guangdong, China. [11]Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China. [12]The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China. [13]Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China. [14]The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. [15]Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [16]Huizhou Municipal Central Hospital, Sun Yat-Sen University, Huizhou, China. [17]Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. [18]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. [19]The Third Affiliated Hospital of Southern Medical University, Guangzhou, China. [20]Institute of Health Management, Southern Medical University, Guangzhou, China. [21]DHC Technologies, Beijing, China. [22]Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China. [23]Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.

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Hypoglycemic pharmacotherapy interventions for alleviating the risk of dementia remains controversial, particularly about dipeptidyl peptidase 4 (DPP4) inhibitors versus metformin. Our objective was to investigate whether the initiation of DPP4 inhibitors, as opposed to metformin, was linked to a reduced risk of dementia.We included individuals with type 2 diabetes over 40 years old who were new users of DPP4 inhibitors or metformin in the Chinese Renal Disease Data System (CRDS) database between 2009 and 2020. The study employed Kaplan-Meier and Cox regression for survival analysis and the Fine and Gray model for the competing risk of death.Following a 1:1 propensity score matching, the analysis included 3626 DPP4 inhibitor new users and an equal number of metformin new users. After adjusting for potential confounders, the utilization of DPP4 inhibitors was associated with a decreased risk of all-cause dementia compared to metformin (hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.45-0.89). Subgroup analysis revealed that the utilization of DPP4 inhibitors was associated with a reduced incidence of dementia in individuals who initiated drug therapy at the age of 60 years or older (HR 0.69, 95% CI 0.48-0.98), those without baseline macrovascular complications (HR 0.62, 95% CI 0.41-0.96), and those without baseline microvascular complications (HR 0.67, 95% CI 0.47-0.98).In this real-world study, we found that DPP4 inhibitors presented an association with a lower risk of dementia in individuals with type 2 diabetes than metformin, particularly in older people and those without diabetes-related comorbidities.© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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出版当年[2023]版：

大类 | 2 区

医学

小类 | 2 区内分泌学与代谢

最新[2025]版：

大类 | 2 区

医学

小类 | 2 区内分泌学与代谢

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出版当年[2022]版：

Q1 ENDOCRINOLOGY & METABOLISM

最新[2023]版：

Q1 ENDOCRINOLOGY & METABOLISM

影响因子： 5 最新[2023版] 5.3 最新五年平均 5.8 出版当年[2022版] 6.1 出版当年五年平均 6.134 出版前一年[2021版] 5 出版后一年[2023版]

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第一作者单位： [1]Institute and Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China.

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