Open AccessEffect of diabetes control status on the progression of Parkinson’s disease: A prospective study
Author(s) -
Ou Ruwei,
Wei Qianqian,
Hou Yanbing,
Zhang Lingyu,
Liu Kuncheng,
Lin Junyu,
Jiang Zheng,
Song Wei,
Cao Bei,
Shang Huifang
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51343
Subject(s) - medicine , hazard ratio , glycated hemoglobin , prospective cohort study , confidence interval , body mass index , proportional hazards model , montreal cognitive assessment , diabetes mellitus , cohort , type 2 diabetes , disease , endocrinology , dementia
Objective To evaluate whether the control status of type 2 diabetes mellitus (DM) influences the progression of Parkinson’s disease (PD). Methods We conducted a prospective cohort study from March 2009 to August 2020. Patients at baseline were categorized into DM and non‐DM groups, and those with DM were further classified into the well and poorly controlled DM groups based on the 7.0% of glycated hemoglobin (HbA1C) levels. Multivariate Cox proportional hazards regression models were used to explore the predictors for PD‐related outcomes by hazard ratios (HRs) and 95% confidence intervals (CIs). Results Of the 379 patients enrolled, 49 (12.9%) had DM, and 22 of DM (44.9%) were poorly controlled. The adjusted HRs were 2.060 (95% CI 1.165‐3.641) for United Rating Scale (UPDRS) III score increased ≥14 in the poorly controlled‐DM group, and 1.066 (95% CI 0.572‐1.986) in the well‐controlled DM group, relative to the non‐DM group ( p trend = 0.025), after adjusting for sex, age, age of onset, body mass index, and UPDRS III and Montreal Cognitive Assessment (MoCA) scores at baseline. The adjusted HRs were 2.079 (95% CI 1.212‐3.566) for reaching Hoehn & Yahr stage ≥3 in the poorly controlled DM group, and 0.879 (95% CI 0.413‐1.871) in the well‐controlled DM group, compared with the non‐DM group ( p trend = 0.021). Time to death or time to MoCA 3‐point decrease were not significantly different among the three groups. Interpretation Poorly controlled DM is an independent risk factor contributing to motor progression in PD. Our study highlights the importance of adequate control of diabetes in PD.