Becker Claudia, Brobert Gunnar P, Johansson Saga, Jick Susan S, Meier Christoph R
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital, Basel, Switzerland.
Diabetes Care. 2008 Sep;31(9):1808-12. doi: 10.2337/dc08-0479. Epub 2008 Jun 16.
Previous observational studies reported inconsistent results on the association between diabetes and Parkinson's disease, and data on the risk of developing incident diabetes in relation to Parkinson's disease are scarce. We aimed at comparing the diabetes prevalence between patients with or without Parkinson's disease and at exploring the risk of developing incident diabetes associated with Parkinson's disease.
We used the U.K.-based General Practice Research Database (GPRD) to 1) compare the diabetes prevalence between Parkinson's disease cases and a matched comparison group free of Parkinson's disease between 1994 and 2005 and to 2) conduct a follow-up study with a nested case-control analysis to quantify the risk of developing new-onset diabetes in association with Parkinson's disease.
The diabetes prevalence was similar in patients with and without Parkinson's disease (adjusted odds ratio [OR] 0.95 [95% CI 0.80-1.14]). In the cohort analysis (incidence rate ratio [IRR] 0.55 [95% CI 0.38-0.81]) and in the nested case-control analysis (adjusted OR 0.53 [95% CI 0.33-0.87]), the risk of developing diabetes was lower in patients with Parkinson's disease than in subjects without. The adjusted OR for patients with Parkinson's disease who were current levodopa users of five or more prescriptions was 0.22 (0.10-0.48) and was 1.11 (0.50-2.45) for Parkinson's disease patients not using levodopa.
In this observational study, diabetes prevalence was closely similar between patients with Parkinson's disease and subjects without. The risk of developing incident diabetes was lower for patients with Parkinson's disease than for patients without, a finding that was limited to Parkinson's disease patients who were using levodopa.
既往观察性研究报道糖尿病与帕金森病之间的关联结果不一致，且关于帕金森病患者发生新发糖尿病风险的数据较少。我们旨在比较帕金森病患者与非帕金森病患者的糖尿病患病率，并探讨帕金森病相关的新发糖尿病风险。
我们使用基于英国的全科医疗研究数据库（GPRD）来：1）比较1994年至2005年间帕金森病病例与匹配的无帕金森病对照组之间的糖尿病患病率；2）进行一项随访研究，并采用巢式病例对照分析来量化帕金森病相关的新发糖尿病风险。
帕金森病患者与非帕金森病患者的糖尿病患病率相似（调整优势比[OR]为0.95[95%可信区间0.80 - 1.14]）。在队列分析中（发病率比[IRR]为0.55[95%可信区间0.38 - 0.81]）以及在巢式病例对照分析中（调整OR为0.53[95%可信区间0.33 - 0.87]），帕金森病患者发生糖尿病的风险低于非帕金森病患者。当前使用左旋多巴处方达5张及以上的帕金森病患者的调整OR为0.22（0.10 - 0.48），未使用左旋多巴的帕金森病患者的调整OR为1.11（0.50 - 2.45）。
在这项观察性研究中，帕金森病患者与非帕金森病患者的糖尿病患病率非常相似。帕金森病患者发生新发糖尿病的风险低于非帕金森病患者，这一发现仅限于使用左旋多巴的帕金森病患者。
