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Variability in metabolic parameters and risk of dementia: a nationwide population-based study

机译：代谢参数的变化和痴呆的风险：一项基于全国人群的研究

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Variability in biological parameters has been reported to be associated with adverse health outcomes. We aimed to investigate the composite effect of the visit-to-visit variability in blood pressure, glucose, cholesterol, and body mass index on the risk of dementia. A population-based cohort study including 2,930,816 subjects without a history of dementia, hypertension, diabetes mellitus, and dyslipidemia who underwent ≥?3 health examinations was performed. The coefficient of variation (CV), standard deviation, and variability independent of the mean were calculated as variability indices. High variability was defined as having values in the highest quartile for each parameter. A total of 32,901 (1.12%) participants developed dementia, of which 74.4% and 11.0% were attributable to Alzheimer’s disease and vascular dementia, respectively, during the median follow-up of 5.5?years. Individuals with higher variability of each parameter were at higher risk of future dementia. In the multivariable adjusted model, the hazard ratios and 95% confidence intervals of all-cause dementia were 1.22 (1.19–1.26) for one parameter, 1.39 (1.35–1.43) for two parameters, 1.54 (1.48–1.60) for three parameters, and 1.73 (1.60–1.88) for four parameters compared with subjects having no parameters of high variability measured as the CV. Consistent results were noted for Alzheimer’s disease and vascular dementia, using other indices of variability and in various sensitivity and subgroup analyses. There was a linear association between the number of high variability parameters and risk of dementia. Reducing variability of metabolic parameters would be a target to preserve cognitive reserve in the general population.
机译：据报道，生物学参数的变化与不良健康后果有关。我们旨在研究血压，血糖，胆固醇和体重指数的访问变异性对痴呆症风险的综合影响。一项基于人群的队列研究包括2,930,816名无痴呆，高血压，糖尿病和血脂异常病史并接受≥3次健康检查的受试者。计算变异系数（CV），标准偏差和独立于平均值的变异性作为变异性指标。高可变性定义为每个参数的最高四分位数中的值。在5.5年的中位随访期间，共有32,901名（1.12％）参与者患了痴呆，其中74.4％和11.0％分别归因于阿尔茨海默氏病和血管性痴呆。每个参数的变异性较高的个体未来痴呆症的风险较高。在多变量调整模型中，全因痴呆的危险度和95％置信区间对于一个参数为1.22（1.19–1.26），对于两个参数为1.39（1.35–1.43），对于三个参数为1.54（1.48-1.60），与没有CV的高变异性参数的受试者相比，四个参数为1.73（1.60-1.88）。使用其他可变性指数以及各种敏感性和亚组分析，发现阿尔茨海默氏病和血管性痴呆的结果一致。高变异性参数的数量与痴呆风险之间存在线性关系。减少代谢参数的可变性将是在一般人群中保持认知储备的目标。

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