二肽基肽酶-4 抑制剂的使用与糖尿病患者帕金森病风险的相关性：一项回顾性队列研究。

Association between dipeptidyl peptidase-4 inhibitor use and risk of Parkinson's disease among patients with diabetes mellitus: a retrospective cohort study.

机构信息

Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan.

Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan.

出版信息

Aging (Albany NY). 2024 Aug 22;16(16):11994-12007. doi: 10.18632/aging.206074.

DOI:10.18632/aging.206074

PMID:39177655

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11386917/

Abstract

BACKGROUND

How a person's Parkinson disease (PD) risk is affected by dipeptidyl peptidase-4 (DPP-4) inhibitors remains unclear. We evaluated the association of PD risk with use of these inhibitors in individuals diagnosed as having diabetes mellitus (DM).

METHODS

Individuals diagnosed as having new-onset DM were enrolled into the case group and comparison group, comprising patients who received a DPP-4 inhibitor and a sulfonylurea, respectively. These groups were matched through propensity score matching on the basis of income level, gender, urbanization level, enrollment year, age, and diabetes complications severity index score. The case group was divided into subgroups on the basis of whether they had a cumulative defined daily dose (cDDD) of <75, 75-150, or >150. The DPP-4 inhibitor-PD risk association was evaluated through a Cox proportional hazards model. The Bonferroni adjustment test was employed to adjust -values and reduce the false positive rate.

RESULTS

Compared with those in the comparison group (treatment with a sulfonylurea), patients with a DPP-4 inhibitor cDDD of >150 had a hazard ratio (HR) of 1.30 for PD development (95% confidence interval [CI]: 0.97-1.73; adjusted = .263); the HRs for patients with a cDDD of <75 or 75-150 were 0.95 (95% CI: 0.71-1.27; adjusted = .886) and 1.06 (95% CI: 0.75-1.50; adjusted = .886), respectively. We noted nonsignificant differences regarding the associations between the use of the various DPP-4 inhibitors (linagliptin, saxagliptin, sitagliptin, and vildagliptin) and PD risk after adjustment for any individual inhibitor (adjusted > .05).

CONCLUSIONS

DPP-4 inhibitors were discovered in this study to not be associated with increased PD risk. This result was confirmed when the analysis was conducted individually for the 4 investigated DPP-4 inhibitors (sitagliptin, saxagliptin, linagliptin, and vildagliptin).

摘要

背景

二肽基肽酶-4（DPP-4）抑制剂如何影响个体患帕金森病（PD）的风险尚不清楚。我们评估了这些抑制剂的使用与新诊断为糖尿病（DM）个体患 PD 风险之间的关联。

方法

新诊断为 DM 的个体被纳入病例组和对照组，分别接受 DPP-4 抑制剂和磺酰脲类药物治疗。根据收入水平、性别、城市化程度、入组年份、年龄和糖尿病并发症严重指数评分，通过倾向评分匹配对这些组进行匹配。根据累积定义日剂量（cDDD）是否<75、75-150 或>150，将病例组分为亚组。采用 Cox 比例风险模型评估 DPP-4 抑制剂与 PD 风险的关联。采用 Bonferroni 调整检验调整 - 值并降低假阳性率。

结果

与对照组（接受磺酰脲类药物治疗）相比，DPP-4 抑制剂 cDDD >150 的患者 PD 发展的风险比（HR）为 1.30（95%置信区间[CI]：0.97-1.73；调整后 =.263）；cDDD <75 或 75-150 的患者 HR 分别为 0.95（95%CI：0.71-1.27；调整后 =.886）和 1.06（95%CI：0.75-1.50；调整后 =.886）。调整任意一种 DPP-4 抑制剂后，我们发现使用各种 DPP-4 抑制剂（利拉利汀、沙格列汀、西他列汀和维格列汀）与 PD 风险之间无显著关联（调整后 >.05）。