Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
J Parkinsons Dis. 2021;11(4):1585-1596. doi: 10.3233/JPD-212725.
A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent.
Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression.
MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD.
A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 -12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26-1.43 p < 0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12-0.60; p < 0.001) and higher UPDRS (SMD 0.60 95%CI 0.28-0.92; p < 0.001) compared with PD patients without DM.
Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.
有人提出糖尿病（DM）和帕金森病（PD）之间存在关联，但证据稀少且不一致。
对所有将 DM 和 PD 联系起来的证据进行系统综述，描述 PD 患者中 DM 的患病率、DM 患者发生 PD 的风险以及 DM 对 PD 严重程度和进展的影响。
检索 MEDLINE、Scopus 和 Cochrane Library 从成立到 2021 年 6 月 30 日的所有内容。纳入报告 DM 和 PD 的患病率、发病率、严重程度和疾病进展的研究。纳入 PD 患者中 DM 的患病率、DM 患者中 PD 的发病率以及 PD 的特征。
共有 21 项研究（n = 11396）纳入了 PD 患者中 DM 患病率的数据，12 项研究（n = 17797221）纳入了 DM 患者中 PD 发病率的数据，10 项研究（n = 2482）纳入了 DM 对 PD 严重程度和疾病进展影响的数据。PD 患者中 DM 的患病率为 10.02%（95%CI 7.88-12.16），DM 患者发生 PD 的风险高于非 DM 患者（OR：1.34，95%CI 1.26-1.43，p < 0.0001），且 PD 合并 DM 的患者运动症状更为严重，Hoehn 和 Yahr 分期更高（SMD：0.36，95%CI 0.12-0.60；p < 0.001），UPDRS 评分更高（SMD 0.60，95%CI 0.28-0.92；p < 0.001）。
尽管 PD 患者中 DM 的患病率与一般人群相似，但 DM 患者发生 PD 的风险更高，且 DM 的存在与 PD 更严重且进展更快相关，这提示 DM 可能是神经退行性变的促进因素。
