Diabetes and risk of Parkinson's disease: a systematic review and meta-analysis.
Diabetes and risk of Parkinson's disease: a systematic review and meta-analysis.
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DOI：
10.2337/dc11-1584
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发表时间：
2011-12
期刊：
影响因子：
16.2
通讯作者：
Pezzoli G
中科院分区：
文献类型：
--
作者：
Cereda E;Barichella M;Pedrolli C;Klersy C;Cassani E;Caccialanza R;Pezzoli G
糖尿病与慢性神经变性有关。我们进行了系统回顾和荟萃分析，以评估既存糖尿病和帕金森病（PD）之间的关系。通过审查合格文献的参考文献，在电子数据库（PubMed、Embase和Scopus）中检索截至2011年5月10日发表的英文原始文献。提供与既存糖尿病和PD相关的风险和精确度估计的前瞻性队列和病例对照研究被认为是合格的。9项研究/1，947篇引文（队列，N = 4;病例对照，N = 5）符合荟萃分析的入选标准。在前瞻性研究中，发现PD发病前糖尿病的发病是未来PD的危险因素（相对危险度[RR] = 1.37 [95%CI 1.21-1.55]; P < 0.0001）。这种关联通过基于排除基线时有血管疾病和/或随访期间发生血管疾病的参与者后得出的估计值的二次分析（RR = 1.34 [1.14-1.58]; P < 0.001）以及通过基线或随访期间与糖尿病相关性的敏感性分析得到证实。然而，病例对照研究发现的相关性不显著（比值比[OR] 0.75 [95%CI 0.50-1.11]; P = 0.835）。根据BMI校正的估计值进行的敏感性分析证实PD与糖尿病之间缺乏相关性（OR 0.56 [0.28-1.15]; P = 0.089）。虽然队列研究的数据表明糖尿病是PD的一个危险因素，但没有确凿的证据表明这种关联。进一步的前瞻性研究集中在假定的致病途径，并考虑到广泛的混杂因素，需要澄清这种关系。
Diabetes has been associated with chronic neurodegeneration. We performed a systematic review and meta-analysis to assess the relationship between pre-existing diabetes and Parkinson’s disease (PD). Original articles in English published up to 10 May 2011 were searched for in electronic databases (PubMed, Embase, and Scopus) and by reviewing references of eligible articles. Prospective cohort and case-control studies providing risk and precision estimates relating to pre-existing diabetes and PD were considered eligible. Nine studies/1,947 citations (cohort, N = 4; case-control, N = 5) fulfilled inclusion criteria for meta-analysis. In prospective studies, the onset of diabetes before onset of PD was found to be a risk factor for future PD (relative risk [RR] = 1.37 [95%CI 1.21–1.55]; P < 0.0001). This association was confirmed by secondary analyses based on estimates derived after the exclusion of participants who had vascular disease at baseline and/or who developed vascular disease during follow-up (RR = 1.34 [1.14–1.58]; P < 0.001) and by sensitivity analyses addressing the association with diabetes at baseline or during follow-up. However, the association found for case-control studies was not significant (odds ratio [OR] 0.75 [95%CI 0.50–1.11]; P = 0.835). Sensitivity analysis based on estimates adjusted for BMI confirmed the lack of a relationship between PD and diabetes (OR 0.56 [0.28–1.15]; P = 0.089). Although data from cohort studies suggest that diabetes is a risk factor for PD, there is no conclusive evidence on this association. Further prospective studies focused on putative pathogenic pathways and taking a broad range of confounders into account is required to clarify this relationship.
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