| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 103 === Objective：Several studies have shown that diabetes is associated with Alzheimer''s diseasebut with conflicting results inrecent years. Therefore
, we aim to investigate whether using oral hypoglycemic agentmetformin in type 2 diabetic patients increases the risk of developing Alzheimer''s disease.
Materials andMethods：This is a retrospective case-control study. Froma databank of Longitudinal Cohort of Diabetes Patients（LHDB）retrieved from national health insurance in Taiwan, we obtained 66,293 type 2 diabetic patients treated with oral hypoglycemic agents during 1999-2011. Risk-set sampling was used to define patients suffering from Alzheimer''s disease, while propensity score was performedfor case pairing with control groups. Conditional logistic regression was used to analyzethe risk of developing Alzheimer''s disease in type 2 diabetic patients treated withMetformin.
Results：There were 872 patients diagnosed with Alzheimer''s diseaseduring this cohort. Among these patients,79.1%(n=690) were treated with metformin,while in the control group (n=3488),74.7% (n=2607) were treated with metformin. Overall, the result shows statistically significant association between metforminuse and the development of Alzheimer''s disease〔adjusted OR 1.28(95% CI 1.03-1.59)〕. Interestingly, diabetes patients with current use, low cumulative dose（≦1000 mg）, low daily dose（≦0.5 DDD/day）, and short duration（≦3 years）had significantly higher risk of developing Alzheimer''s disease［adjusted OR（95% CI）of current use；low cumulative dose；low daily dose；short duration：2.88（2.20-3.79）；1.29（1.01-1.65）；1.39（1.11-1.74）；1.27（1.02-1.58）, respectively.］
Conclusion：Among diabetes patients older than 65 years of age,increased risk of Alzheimer''s disease under current using metformin was proved. Furthermore, low dose and short duration use of metformin also have higher risk in developing Alzheimer''s disease.
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