Association between diabetes and subsequent Parkinson disease A record-linkage cohort study
Association between diabetes and subsequent Parkinson disease A record-linkage cohort study
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DOI：
10.1212/wnl.0000000000005771
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发表时间：
2018-07-10
期刊：
影响因子：
9.9
通讯作者：
Warner, Thomas T.
中科院分区：
文献类型：
--
作者：
De Pablo-Fernandez, Eduardo;Goldacre, Raph;Warner, Thomas T.
目的探讨2型糖尿病（T2DM）与继发帕金森病（PD）的关系。方法采用1999-2011年英国国家医院事件统计和死亡率数据进行回顾性队列研究。构建了一个编码诊断为T2DM的住院治疗个体队列，并与参考队列进行比较。使用Cox回归模型估计后续PD风险。被编码诊断为脑血管疾病、血管性帕金森病、药物性帕金森病和常压脑积水的个体被排除在分析之外。结果T2DM组共有2,017,115人，参考组有6,173,208人。T2DM患者PD发生率显著升高（风险比[HR] 1.32, 95%可信区间[CI] 1.29-1.35; p < 0.001）。在合并T2DM的人群中（HR 1.49, 95% CI 1.42-1.56）和年轻人群中（HR 3.81, 95% CI 2.84-5.11, 25-44岁），相对增加更大。结论：在这项大型队列研究中，我们报告T2DM后PD发生率增加。这些发现可能反映了共同的遗传易感性和/或破坏了共同的致病途径，具有潜在的临床和治疗意义。
ObjectiveTo investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD).MethodsLinked English national Hospital Episode Statistics and mortality data (1999-2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort. Subsequent PD risk was estimated using Cox regression models. Individuals with a coded diagnosis of cerebrovascular disease, vascular parkinsonism, drug-induced parkinsonism, and normal pressure hydrocephalus were excluded from the analysis.ResultsA total of 2,017,115 individuals entered the T2DM cohort and 6,173,208 entered the reference cohort. There were significantly elevated rates of PD following T2DM (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.29-1.35; p < 0.001). The relative increase was greater in those with complicated T2DM (HR 1.49, 95% CI 1.42-1.56) and when comparing younger individuals (HR 3.81, 95% CI 2.84-5.11 in age group 25-44 years).ConclusionsWe report an increased rate of subsequent PD following T2DM in this large cohort study. These findings may reflect shared genetic predisposition and/or disrupted shared pathogenic pathways with potential clinical and therapeutic implications.