Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Neurology Division, Internal Medicine Department, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Metab Brain Dis. 2020 Oct;35(7):1067-1075. doi: 10.1007/s11011-020-00568-5. Epub 2020 May 4.
Lately, focus on the relation between Parkinson's disease (PD) and Diabetes has risen greatly, as neuroprotective properties have been attributed to insulin use. Several studies have assessed the effect of glitazones, an insulin-sensitizing agent, in diabetic population on PD future risk. However, reports on the effect of their use have been heterogeneous. We aimed to synthesize the available scientific evidence which assesses the effect of glitazone use in type 2 diabetes patients on PD incidence. A systematic review was performed on multiple electronic databases. Considered for inclusion were studies that assessed the incidence of PD in type 2 diabetes glitazone users. Two reviewers worked independently and in duplicate to assess all studies, extract information and assess the methodological quality in each included study. Four high quality retrospective cohorts fulfilled inclusion criteria. Comparison groups varied across studies. In each study, incidence of PD was lower in glitazone-exposed patients compared to their respective comparison group. Pooled analysis showed lesser risk of PD in ever versus never glitazone users (RR 0.75 [95% C.I. 0.67-0.85; p < .0001; I = 0]). Our pooled analysis showed lesser risk of PD in glitazone versus non glitazone users, however, we advise to take results with caution since results are non-adjusted to possible confounding variables, furthermore, different glitazone-exposure time, follow up and comparison groups are aspects that also need to be pointed out. More clinical research focused on glitazone use and its relation with PD is needed, as this could result in new potential treatment modalities.
最近，人们对帕金森病 (PD) 与糖尿病之间的关系关注度大大增加，因为人们认为胰岛素具有神经保护作用。一些研究评估了胰岛素增敏剂格列酮类药物在糖尿病患者中的使用对 PD 未来风险的影响。然而，关于其使用效果的报告结果并不一致。我们旨在综合评估评估 2 型糖尿病患者使用格列酮类药物对 PD 发病率影响的现有科学证据。我们在多个电子数据库中进行了系统评价。纳入的研究评估了 2 型糖尿病格列酮使用者 PD 的发病率。两名评审员独立并重复地评估所有研究，提取信息并评估每个纳入研究的方法学质量。四项高质量的回顾性队列研究符合纳入标准。各研究的对照组不同。在每项研究中，与相应对照组相比，格列酮暴露患者的 PD 发病率较低。汇总分析显示，与从不使用格列酮相比，曾经使用格列酮的患者 PD 风险较低（RR 0.75 [95% CI 0.67-0.85；p < 0.0001；I = 0]）。我们的汇总分析显示，与不使用格列酮相比，使用格列酮的患者 PD 风险较低，但我们建议谨慎对待这些结果，因为这些结果没有调整可能的混杂变量，此外，不同的格列酮暴露时间、随访和对照组也是需要指出的方面。需要更多关注格列酮使用及其与 PD 之间关系的临床研究，因为这可能会产生新的潜在治疗方法。
