Kwon Mi Jung, Kim Jwa-Kyung, Kim Ji Hee, Kim Joo-Hee, Kim Min-Jeong, Kim Nan Young, Choi Hyo Geun, Kim Eun Soo
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea.
Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea.
Nutrients. 2023 Jul 19;15(14):3205. doi: 10.3390/nu15143205.
Chronic kidney disease (CKD) and Parkinson's disease (PD) are common illnesses found in the geriatric population. A potential link between CKD and PD emergence has been hypothesized; however, existing conclusions are disputed. In this longitudinal research, we analyzed data acquired from the Korean National Health Insurance Service-Health Screening Cohort. The dataset comprised the health information of 16,559 individuals clinically diagnosed with CKD and 66,236 control subjects of comparable ages, all aged ≥40 years. These subjects participated in health examinations from 2002 to 2019. To assess the correlation between CKD and PD, we employed overlap-weighted Cox proportional hazard regression models. The unadjusted, crude hazard ratio for PD was greater in the CKD group than in the control group (crude hazard ration (HR) 1.20; 95% confidence interval (CI) = 1.04-1.39; = 0.011). However, the Cox proportional hazard regression analysis, incorporating propensity score overlap weighting, revealed no significant discrepancy after considering confounding variables such as demographic factors, socio-economic status, lifestyle, and concurrent health conditions (adjusted HR (aHR), 1.09; 95% CI = 0.97-1.22; = 0.147). Subgroup analyses showed a higher probability of PD development among certain CKD individuals, including those who resided in rural areas (aHR, 1.19; 95% CI = 1.03-1.37; = 0.022), maintained a normal weight (aHR, 1.29; 95% CI = 1.08-1.56; = 0.006), or had fasting blood glucose levels ≥100 mg/dL (aHR, 1.18; 95% CI = 1.00-1.39; = 0.046). Therefore, these clinical or environmental factors may influence the incidence of PD in CKD patients. In conclusion, our results suggest that the general CKD population may not exhibit a greater propensity for PD than their non-CKD counterparts. However, this might be contingent upon specific lifestyle and comorbid conditions. Thus, certain lifestyle alterations could be crucial in mitigating the potential manifestation of PD in patients diagnosed with CKD.
慢性肾脏病(CKD)和帕金森病(PD)是老年人群中的常见疾病。已有研究推测CKD与PD的发生之间可能存在联系;然而,现有结论存在争议。在这项纵向研究中,我们分析了从韩国国民健康保险服务健康筛查队列中获取的数据。该数据集包含16559名临床诊断为CKD的个体以及66236名年龄相仿的对照对象(年龄均≥40岁)的健康信息。这些受试者在2002年至2019年期间参加了健康检查。为了评估CKD与PD之间的相关性,我们采用了重叠加权Cox比例风险回归模型。CKD组中未调整的PD粗风险比高于对照组(粗风险比(HR)为1.20;95%置信区间(CI)=1.04 - 1.39;P = 0.011)。然而,纳入倾向得分重叠加权的Cox比例风险回归分析显示,在考虑了人口统计学因素、社会经济地位、生活方式和并发健康状况等混杂变量后,没有显著差异(调整后HR(aHR)为1.09;95%CI = 0.97 - 1.22;P = 0.147)。亚组分析显示,某些CKD个体发生PD的概率较高,包括居住在农村地区的个体(aHR为1.19;95%CI = 1.03 - 1.37;P = 0.022)、体重正常的个体(aHR为1.29;95%CI = 1.08 - 1.56;P = 0.006)或空腹血糖水平≥100mg/dL的个体(aHR为1.18;95%CI = 1.00 - 1.39;P = 0.046)。因此,这些临床或环境因素可能会影响CKD患者中PD的发病率。总之,我们的结果表明,一般CKD人群发生PD的倾向可能并不高于非CKD人群。然而,这可能取决于特定的生活方式和合并症。因此,某些生活方式的改变对于减轻诊断为CKD的患者中PD的潜在表现可能至关重要。