Department of Nursing, Steyer School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Israel.
Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Israel.
Parkinsonism Relat Disord. 2024 Nov;128:107132. doi: 10.1016/j.parkreldis.2024.107132. Epub 2024 Sep 6.
Emerging evidence suggests a potential association between certain anti-diabetic drugs and a reduced risk of Parkinson's disease (PD). Limited population-based studies have investigated users of newer anti-diabetic drugs such as GLP-1 agonists or SGLT2 inhibitors.
The aim of this study was to assess the risk of PD among individuals with type 2 diabetes mellitus (T2DM) who were treated with various types of anti-diabetic drugs over time.
A population-based cohort comprising T2DM patients aged over 30 who used metformin, GLP-1 agonists, thiazolidinediones, sulfonylureas, DPP4 inhibitors, SGLT2 inhibitors, or meglitinides between January 1, 1999 and December 31, 2018. Data were obtained between the diabetes registration and drug purchase databases of Maccabi Healthcare Services. Time-dependent Cox regression models, adjusted for sex, age, and comorbidities were employed to calculate the adjusted hazard ratios (HRs) for the PD risk associated with different anti-diabetic drugs over time.
The study population comprised 86,229 T2DM patients, with 53.9 % males. The mean age at the first anti-diabetic drug purchase was 59.0 ± 11.0 and 62.0 ± 11.0 years for men and women respectively. Compared to metformin, several drug types were associated with a significantly lower PD risk: thiazolidinediones (HR = 0.91, 95 % CI:0.074-1.14); DPP4 inhibitors (HR = 0.60, 95 % CI:0.53-0.67); meglitinides (HR = 0.63, 95 % CI:0.53-0.74); GLP-1 agonists (HR = 0.54, 95 % CI:0.39-0.73); and SGLT2 inhibitors (HR = 0.15, 95 % CI:0.10-0.21).
Our results suggest a reduced risk of PD with certain anti-diabetic drugs, particularly SGLT2 inhibitors and GLP-1 agonists. Validation through extensive big-data studies is essential to confirm these results and to optimize PD prevention and management.
新出现的证据表明，某些抗糖尿病药物与帕金森病（PD）风险降低之间存在潜在关联。有限的基于人群的研究调查了新型抗糖尿病药物（如 GLP-1 激动剂或 SGLT2 抑制剂）使用者的情况。
本研究旨在评估随着时间的推移，使用各种类型的抗糖尿病药物治疗的 2 型糖尿病（T2DM）患者患 PD 的风险。
这项基于人群的队列研究纳入了 1999 年 1 月 1 日至 2018 年 12 月 31 日期间在 Maccabi 医疗保健服务中心糖尿病登记和药物购买数据库中使用二甲双胍、GLP-1 激动剂、噻唑烷二酮、磺酰脲类、DPP4 抑制剂、SGLT2 抑制剂或格列奈类药物的年龄超过 30 岁的 T2DM 患者。采用时间依赖性 Cox 回归模型，根据性别、年龄和合并症对不同抗糖尿病药物与 PD 风险相关的调整后危险比（HRs）进行了校正。
该研究人群包括 86229 名 T2DM 患者，其中 53.9%为男性。首次使用抗糖尿病药物时的平均年龄为 59.0±11.0 岁，男性和女性分别为 62.0±11.0 岁。与二甲双胍相比，几种药物类型与 PD 风险显著降低相关：噻唑烷二酮类（HR=0.91，95%CI：0.074-1.14）；DPP4 抑制剂（HR=0.60，95%CI：0.53-0.67）；格列奈类（HR=0.63，95%CI：0.53-0.74）；GLP-1 激动剂（HR=0.54，95%CI：0.39-0.73）；SGLT2 抑制剂（HR=0.15，95%CI：0.10-0.21）。
我们的研究结果表明，某些抗糖尿病药物（特别是 SGLT2 抑制剂和 GLP-1 激动剂）可降低 PD 风险。通过广泛的大数据研究进行验证对于确认这些结果以及优化 PD 的预防和管理至关重要。
