Division of Neurology, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, 35053, Taiwan.
Sci Rep. 2023 Dec 15;13(1):22489. doi: 10.1038/s41598-023-49870-z.
Diabetes mellitus is a risk factor for Parkinson's disease (PD). While animal studies have supported the benefits of incretin-based therapies, including dipeptidyl peptidase-4 (DPP4) inhibitors, in PD, clinical research has yielded controversial results. This cohort study aimed to assess the relationship between PD incidence and the utilization of DPP4 inhibitor in diabetic patients. Using Taiwan's National Health Insurance Research Database from 2009 to 2018, diabetic patients receiving metformin plus at least one second-line oral antidiabetic (OAD) were enrolled. The patients were categorized as DPP4 inhibitor users and non-users. Propensity score matching was employed to establish a 1:1 ratio between DPP4 inhibitor users and non-users. Among the 205,910 patients enrolled, 149 were diagnosed with PD during follow-up. The incidence rate was 0.29 per 1000 person-years for DPP4 inhibitor users and 0.55 per 1000 person-years for the non-users. DPP4 inhibitor users exhibited a significantly lower risk of PD (adjusted hazard ratio, 0.51; 95% CI 0.39-0.68). Among DPP4 inhibitor users, vildagliptin showed the strongest correlation with a reduction in the risk of PD. This study demonstrates that the use of DPP4 inhibitors along with metformin in diabetic patients is associated with a lower risk of PD compared to those using other OADs.
糖尿病是帕金森病（PD）的一个风险因素。虽然动物研究支持肠促胰岛素疗法，包括二肽基肽酶-4（DPP4）抑制剂，对 PD 有益，但临床研究却得出了有争议的结果。这项队列研究旨在评估 PD 发病率与糖尿病患者使用 DPP4 抑制剂之间的关系。该研究使用了台湾 2009 年至 2018 年的全民健康保险研究数据库，纳入了接受二甲双胍加至少一种二线口服降糖药（OAD）的糖尿病患者。患者被分为 DPP4 抑制剂使用者和非使用者。采用倾向评分匹配法建立了 DPP4 抑制剂使用者和非使用者的 1:1 比例。在纳入的 205910 名患者中，有 149 名在随访期间被诊断为 PD。DPP4 抑制剂使用者的发病率为 0.29/1000 人年，而非使用者的发病率为 0.55/1000 人年。DPP4 抑制剂使用者发生 PD 的风险显著降低（调整后的危险比为 0.51；95%CI 0.39-0.68）。在 DPP4 抑制剂使用者中，维格列汀与 PD 风险降低的相关性最强。本研究表明，与使用其他 OAD 相比，糖尿病患者使用二甲双胍联合 DPP4 抑制剂与 PD 风险降低相关。
