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To investigate the relationship between different obesity statuses in patients with cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM) and the incidence of all-cause dementia and its subtypes.
Based on data from the UK Biobank, study subjects were categorized into five obesity states—underweight, normal weight, simple central or simple generalized obesity, combined overweight, and combined obesity—according to BMI and waist circumference. The Cox proportional hazards regression model was employed to analyze the hazard ratios (HR) and 95% confidence intervals (CI) for dementia incidence among patients with cardiovascular metabolic diseases across different obesity statuses.
A total of 63 066 CVD patients and 33 872 T2DM patients were included in the study. Compared to normal weight CVD patients, underweight individuals exhibited a 135% increased risk of vascular dementia (VD) (HR=2.35, 95%CI: 1.09-5.09). The risk of all-cause dementia and Alzheimer’s disease (AD) in patients with simple central or simple generalized obesity decreased by 26% (0.74, 0.61-0.90) and 30% (0.70, 0.51-0.95),respectively. For combined overweight patients, the risk of all-cause dementia and AD decreased by 28% (0.72, 0.64-0.82) and 29%(0.71, 0.58-0.87), respectively. In combined obesity patients, the risk of all-cause dementia, AD, and VD decreased by 35% (0.65,0.58-0.74), 40% (0.60, 0.49-0.74), and 27% (0.73, 0.57-0.93), respectively. Compared to normal weight T2DM patients, combined overweight patients showed a 39% (0.61, 0.46-0.81) and 46% (0.54, 0.36-0.81) reduction in the risk of all-cause dementia and AD,respectively. The risk of all-cause dementia, AD, and VD in combined obesity patients decreased by 35% (0.53, 0.41-0.69), 40%(0.45, 0.31-0.66), and 27% (0.53, 0.32-0.87), respectively.
There is an “obesity paradox” in dementia risk among patients with cardiovascular metabolic diseases, with a significant reduction in the incidence of dementia among patients with simple central or simple generalized obesity, combined overweight, and combined obesity.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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