Chang Yoonkyung, Park Ju-Young, Song Tae-Jin
Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Applied Statistics, Yonsei University, Seoul, 03722, South Korea.
Sci Rep. 2025 Jan 16;15(1):2142. doi: 10.1038/s41598-025-85672-1.
The association between insulin resistance and increased risk of Parkinson's disease (PD) has rarely been investigated. Our study aimed to investigate the association between the triglyceride/high-density lipoprotein (TG/HDL) ratio (which represents insulin resistance), and the incidence risk of PD in the general population. This study was conducted using data from the National Health Insurance Service-Health Screening Cohort Database of South Korea (2002-2019). We enrolled 310,023 participants who had no previous PD history and who had undergone more than three repeated measurements for the TG/HDL cholesterol ratio. The diagnosis of PD was determined using the International Classification of Diseases, 10th Revision code G20, specific reimbursement codes for Rare Intractable Diseases of V124, and a history of anti-PD drug prescription. During a median of 9.64 years (interquartile range 8.72-10.53), 4,587 individuals (1.47%) had an incidence of PD. Considering the multivariable time-dependent Cox proportional hazard model with repeated measures of average TG/HDL cholesterol ratio, a per unit increase in TG/HDL cholesterol ratio significantly increased the risk of PD in the entire cohort (hazard ratio (HR), 1.010; 95% confidence interval (CI), 1.001-1.020). These repeated measures of the average TG/HDL cholesterol ratio were associated with the incidence risk of PD in a J-shaped pattern for the entire diabetes mellitus (DM) and non-DM cohorts in restricted cubic spline analysis. Compared to the lowest tertiles (T1), the highest tertiles (T3) were positively associated with the incidence risk of PD (HR: 1.149, 95% CI 1.065-1.239 in the entire cohort, p for trend < 0.001; HR: 1.175, 95% CI 1.075-1.285 in the non-DM cohort, p for trend < 0.001). In contrast, the lowest (T1) and highest tertiles (T3) were not associated with the incidence risk of PD in the DM cohort (HR: 1.128, 95% CI 0.909-1.348) in fully adjusted multivariable analysis. Our study provides information that TG/HDL ratio may be positively associated with PD incidence risk in a non-DM population in longitudinal setting of the general population.
胰岛素抵抗与帕金森病（PD）风险增加之间的关联鲜有研究。我们的研究旨在调查甘油三酯/高密度脂蛋白（TG/HDL）比值（代表胰岛素抵抗）与普通人群中PD发病风险之间的关联。本研究使用了韩国国民健康保险服务健康筛查队列数据库（2002 - 2019年）的数据。我们纳入了310,023名既往无PD病史且对TG/HDL胆固醇比值进行过三次以上重复测量的参与者。PD的诊断依据国际疾病分类第10版代码G20、罕见难治性疾病的特定报销代码V124以及抗PD药物处方史来确定。在中位时间9.64年（四分位间距8.72 - 10.53年）期间，4,587人（1.47%）发生了PD。考虑到采用平均TG/HDL胆固醇比值重复测量的多变量时间依赖性Cox比例风险模型，TG/HDL胆固醇比值每增加一个单位，整个队列中PD的风险显著增加（风险比（HR），1.010；95%置信区间（CI），1.001 - 1.020）。在受限立方样条分析中，对于整个糖尿病（DM）和非DM队列，这些平均TG/HDL胆固醇比值的重复测量与PD发病风险呈J形关联。与最低三分位数（T1）相比，最高三分位数（T3）与PD发病风险呈正相关（在整个队列中HR：1.149，95% CI 1.065 - 1.239，趋势p < 0.001；在非DM队列中HR：1.175，95% CI 1.075 - 1.285，趋势p < 0.001）。相比之下，在完全调整的多变量分析中，最低（T1）和最高三分位数（T3）与DM队列中PD的发病风险无关（HR：1.128，95% CI 0.909 - 1.348）。我们的研究提供了信息，即在普通人群的纵向研究中，TG/HDL比值可能与非DM人群中PD的发病风险呈正相关。
