The Impact of Type 2 Diabetes in Parkinson's Disease

被引：73

作者：

Athauda, Dilan ^{[1
,2
,3
]}

Evans, James ^{[1
,2
]}

Wernick, Anna ^{[1
,2
]}

Virdi, Gurvir ^{[1
,2
]}

Choi, Minee L. ^{[1
,2
]}

Lawton, Michael ^{[4
]}

Vijiaratnam, Nirosen ^{[3
]}

Girges, Christine ^{[3
]}

Ben-Shlomo, Yoav ^{[4
]}

Ismail, Khalida ^{[5
]}

Morris, Huw ^{[3
]}

Grosset, Donald ^{[6
]}

Foltynie, Thomas ^{[3
]}

Gandhi, Sonia ^{[1
,2
,3
]}

机构：

[1] Francis Crick Inst, Neurodegenerat Biol Lab, London, England

[2] UCL Queen Sq Inst Neurol, London, England

[3] UCL Queen Sq Inst Neurol, Dept Clin & Movement Neurosci, London WC1N 3BG, England

[4] Univ Bristol, Sch Social & Community Med, Bristol, Avon, England

[5] Kings Coll London, Dept Psychol Med, London, England

[6] Queen Elizabeth Univ Hosp, Inst Neurol Sci, Glasgow, Lanark, Scotland

来源：

MOVEMENT DISORDERS | 2022年 / 37卷 / 08期

关键词：

Parkinson's; type; 2; diabetes; disease progression; cognitive impairment; QUALITY-OF-LIFE; COGNITIVE IMPAIRMENT; ALZHEIMERS-DISEASE; INSULIN-RESISTANCE; HEALTH-STATUS; RISK; DEPRESSION; DISORDERS; METFORMIN; DEMENTIA;

D O I：

10.1002/mds.29122

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Type 2 diabetes (T2DM) is an established risk factor for developing Parkinson's disease (PD), but its effect on disease progression is not well understood. Objective The aim of this study was to investigate the influence of T2DM on aspects of disease progression in PD. Methods We analyzed data from the Tracking Parkinson's study to examine the effects of comorbid T2DM on PD progression and quality of life by comparing symptom severity scores assessing a range of motor and nonmotor symptoms. Results We identified 167 (8.7%) patients with PD and T2DM (PD + T2DM) and 1763 (91.3%) patients with PD without T2DM (PD). After controlling for confounders, patients with T2DM had more severe motor symptoms, as assessed by Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (25.8 [0.9] vs. 22.5 [0.3] P = 0.002), and nonmotor symptoms, as assessed by Non-Motor Symptoms Scale total (38.4 [2.5] vs. 31.8 [0.7] P < 0.001), and were significantly more likely to report loss of independence (odds ratio, 2.08; 95% confidence interval [CI]: 1.34-3.25; P = 0.001) and depression (odds ratio, 1.62; CI: 1.10-2.39; P = 0.015). Furthermore, over time, patients with T2DM had significantly faster motor symptom progression (P = 0.012), developed worse mood symptoms (P = 0.041), and were more likely to develop substantial gait impairment (hazard ratio, 1.55; CI: 1.07-2.23; P = 0.020) and mild cognitive impairment (hazard ratio, 1.7; CI: 1.24-2.51; P = 0.002) compared with the PD group. Conclusions In the largest study to date, T2DM is associated with faster disease progression in Parkinson's, highlighting an interaction between these two diseases. Because it is a potentially modifiable metabolic state, with multiple peripheral and central targets for intervention, it may represent a target for alleviating parkinsonian symptoms and slowing progression to disability and dementia. (c) 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

引用

页码：1612 / 1623

页数：12

共 59 条

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