Abstract
BackgroundInsulin resistance is suggested to have negative effects on cognition; however, results from large population studies are lacking. In this study, the potential relationships between the triglyceride glucose (TyG) index, a simple surrogate marker of insulin resistance, and dementia were evaluated using a large-scale population dataset.MethodsThis was a retrospective, observational, cohort study using data from the National Health Information Database from 2009 to 2015 and included 5,586,048 participants 40 years age or older. The TyG index was used as a measure of insulin resistance, and participants were divided into quartiles based on TyG index. The incidence of dementia was assessed using hazard ratios (HRs) estimated with Cox proportional hazard modeling.ResultsDuring a median follow-up of 7.21 years, dementia was diagnosed in 142,714 (2.55%) participants. Alzheimer’s disease (AD) and vascular dementia (VD) were diagnosed in 74.3% and 12.5% of the participants. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for dementia (HRs = 1.14; 95% confidence interval [CI] 1.12–1.16), AD (HRs = 1.12; 95% CI 1.09–1.14), and VD (HRs = 1.18; 95% CI 1.12–1.23) compared with the 1st quartile of TyG index; however, this had a small effect size (Cohen’s d = 0.10, 0.08, and 0.13, respectively). These effects were independent of age, sex, smoking status, physical activity, body mass index, systolic blood pressure, and total cholesterol.ConclusionIn this large population study, TyG index was associated with an increased risk of dementia, including AD and VD, that was independent of traditional cardiovascular risk factors, although the effect size of the TyG index was small.
Highlights
Dementia, an aging-related disease, is a progressive neurodegenerative disorder clinically characterized by deterioration in memory, thinking, behavior, and the ability to perform everyday activities, and is one of the major causes of disability and dependency among olderInsulin resistance is a state of decreased responsiveness of target tissues to insulin, and a major feature of type 2 diabetes, glucose intolerance, hypertension,(2021) 13:9 dyslipidemia, and cardiovascular disease
The triglyceride glucose (TyG) index across quartiles was positively associated with age, body mass index (BMI), waist circumference, current smoking, alcohol consumption, systolic and diastolic Blood pressure (BP), fasting glucose, total cholesterol, Low-density lipoprotein (LDL) cholesterol, triglyceride, high prevalence of type 2 diabetes, hypertension, dyslipidemia, and Chronic kidney disease (CKD)
AD Alzheimer’s disease, VD vascular dementia, TyG triglyceride glucose index, HR hazard ratio, CI confidence interval Model 1: age, sex Model 2: age, sex, smoking status, alcohol consumption, physical activity, low income, body mass index (BMI), hypertension, total cholesterol level quartiles with small effect sizes (Cohen’s d): 1.03, 1.05, and 1.12 for the 2nd, 3rd, and 4th quartiles, respectively, compared with the 1st quartile (p for trend < 0.001, Table 2)
Summary
An aging-related disease, is a progressive neurodegenerative disorder clinically characterized by deterioration in memory, thinking, behavior, and the ability to perform everyday activities, and is one of the major causes of disability and dependency among olderInsulin resistance is a state of decreased responsiveness of target tissues to insulin, and a major feature of type 2 diabetes, glucose intolerance, hypertension,(2021) 13:9 dyslipidemia, and cardiovascular disease. In several recent studies that involved both human and animal models, insulin resistance was suggested to have negative effects on cognition, learning and memory [7, 8]; evidence for the association between insulin resistance and dementia from large population studies is lacking. The potential relationships between the TyG index and dementia were evaluated using a large-scale population dataset from the National Health Information Database (NHID). Insulin resistance is suggested to have negative effects on cognition; results from large population studies are lacking. The potential relationships between the triglyceride glucose (TyG) index, a simple surrogate marker of insulin resistance, and dementia were evaluated using a large-scale population dataset
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