Department of Neurology, People's Hospital of Henan University, Zhengzhou, Henan, 450003, China.
Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
BMC Public Health. 2024 Aug 15;24(1):2225. doi: 10.1186/s12889-024-19709-x.
Parkinson's disease (PD) is a neurodegenerative influenced by various clinical factors. The potential relationship between renal function and the risk of PD remains poorly understood. This study aims to explore the association between kidney function and the risk of developing PD.
A population-based cohort study was conducted using data from 400,571 UK Biobank participants. Renal function was assessed using the estimated glomerular filtration rate (eGFR), calculated from serum creatinine and cystatin C levels. The association between eGFR levels and PD risk was evaluated using univariate and multivariate Cox regression analyses, Restricted Cubic Spline (RCS) analysis, and Kaplan-Meier analysis. Additionally, a clinical prediction model was developed and its diagnostic accuracy was evaluated using ROC analysis. A heatmap was also constructed to examine the relationship between clinical factors and gray matter volume in various brain regions.
Over a median observation period of 13.8 years, 2740 PD events were recorded. Cox regression and Kaplan-Meier analyses revealed a significant association between decreased eGFR and increased PD risk, particularly in participants with eGFR < 30 ml/min/1.73 m. This association was confirmed across three adjusted models. RCS analysis demonstrated a nonlinear relationship between decreasing eGFR and increasing PD risk. Furthermore, changes in eGFR were correlated with alterations in subcortical gray matter volume in regions such as the frontal cortex, striatum, and cerebellum. The clinical prediction model showed high diagnostic accuracy with AUC values of 0.776, 0.780, and 0.824 for 4-, 8-, and 16-year predictions, respectively.
Renal insufficiency is significantly associated with an increased risk of PD, highlighting the importance of maintaining good kidney function as a potential preventive measure against PD.
帕金森病（PD）是一种受多种临床因素影响的神经退行性疾病。肾功能与 PD 风险之间的潜在关系尚未被充分了解。本研究旨在探讨肾功能与 PD 发病风险之间的关联。
本研究使用来自英国生物库 400571 名参与者的数据进行了一项基于人群的队列研究。使用基于血清肌酐和胱抑素 C 水平的估算肾小球滤过率（eGFR）来评估肾功能。使用单变量和多变量 Cox 回归分析、限制性三次样条（RCS）分析和 Kaplan-Meier 分析评估 eGFR 水平与 PD 风险之间的关联。此外，还开发了一个临床预测模型，并使用 ROC 分析评估其诊断准确性。还构建了热图，以检查各种脑区的临床因素与灰质体积之间的关系。
在中位观察期为 13.8 年期间，记录到 2740 例 PD 事件。Cox 回归和 Kaplan-Meier 分析显示，eGFR 降低与 PD 风险增加之间存在显著关联，尤其是在 eGFR<30 ml/min/1.73 m 的参与者中。该关联在三个调整后的模型中均得到确认。RCS 分析表明，eGFR 下降与 PD 风险增加之间存在非线性关系。此外，eGFR 的变化与前额皮质、纹状体和小脑等区域的皮质下灰质体积的变化相关。临床预测模型的 AUC 值分别为 0.776、0.780 和 0.824，具有较高的诊断准确性，可用于 4 年、8 年和 16 年的预测。
肾功能不全与 PD 风险增加显著相关，这强调了保持良好肾功能作为预防 PD 的潜在措施的重要性。
