Department of Neurology, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
Department of Medicine, Federal University of Vicosa (UFV), Vicosa, MG, Brazil.
J Parkinsons Dis. 2024;14(6):1237-1242. doi: 10.3233/JPD-240104.
Impaired glucose and energy metabolism has been suggested as a pathogenic mechanism underlying Parkinson's disease (PD). In recent cohorts, phosphoglycerate kinase 1 activators (PGK1a) have been associated with a lower incidence of PD when compared with other antiprostatic agents that do not activate PGK1.
We aimed to perform a systematic review and meta-analysis comparing the incidence of PD in patients taking PGK1a versus tamsulosin.
We searched PubMed, Embase, and Cochrane Library for studies comparing PGK1a vs. tamsulosin in adults and elderly. The primary outcome was the incidence of PD. We computed hazard ratios (HR) for binary endpoints, with 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager 5.4 and R (version 4.3.1).
A total of 678,433 participants from four cohort studies were included, of whom 287,080 (42.3%) received PGK1a. Mean age ranged from 62 to 74.7 years and nearly all patients were male. Patients taking PGK1a had a lower incidence of PD (PGK1a 1.04% vs. tamsulosin 1.31%; HR 0.80; 95% CI 0.71-0.90; p < 0.01). This result remained consistent in a sensitivity analysis excluding patients of age 60 years old or younger (PGK1a 1.21% vs. tamsulosin 1.42%; HR 0.82; 95% CI 0.71-0.95; p < 0.01).
Glycolysis-enhancing drugs are associated with a lower incidence of PD when compared with tamsulosin in adults and elderly individuals with prostatic disease in use of alpha-blockers. Our findings support the notion of glycolysis as a potential neuroprotective mechanism in PD. Future investigations with randomized controlled trials are needed.
葡萄糖和能量代谢受损被认为是帕金森病（PD）的发病机制。在最近的队列研究中，与其他不激活 PGK1 的抗前列腺药物相比，磷酸甘油酸激酶 1 激活剂（PGK1a）与 PD 的发病率较低相关。
我们旨在进行系统评价和荟萃分析，比较服用 PGK1a 与坦索罗辛的患者中 PD 的发病率。
我们在 PubMed、Embase 和 Cochrane Library 中搜索了比较成人和老年人中 PGK1a 与坦索罗辛的研究。主要结局是 PD 的发病率。我们计算了二项终点的风险比（HR），置信区间（CI）为 95%。使用 Review Manager 5.4 和 R（版本 4.3.1）进行统计分析。
共有 4 项队列研究的 678433 名参与者入组，其中 287080 名（42.3%）接受了 PGK1a 治疗。平均年龄范围为 62 至 74.7 岁，几乎所有患者均为男性。服用 PGK1a 的患者 PD 发病率较低（PGK1a 为 1.04%，坦索罗辛为 1.31%；HR 0.80；95%CI 0.71-0.90；p<0.01）。在排除年龄 60 岁或以下的患者的敏感性分析中，这一结果仍然一致（PGK1a 为 1.21%，坦索罗辛为 1.42%；HR 0.82；95%CI 0.71-0.95；p<0.01）。
与坦索罗辛相比，在使用α受体阻滞剂的前列腺疾病成年和老年患者中，增强糖酵解的药物与 PD 发病率较低相关。我们的研究结果支持糖酵解作为 PD 潜在神经保护机制的观点。需要进一步进行随机对照试验的研究。
