Parkinson's Disease and Type 2 Diabetes: <scp>HbA1c</scp> Is Associated with Motor and Cognitive Severity

Huxford, Brook; Haque, Tahrina; Joseph, Aaron Ben; Simonet, Cristina; Gallagher, D.; Budu, Caroline; Dobson, Ruth; Noyce, Alastair J.

doi:10.1002/mds.28829

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…Although there was a weak association of diabetes with H&Y stages, we did not observe this relationship with MDS‐UPDRS III in our study, which is likely due to the long disease duration and more advanced disease stages of PD patients in our study. However, we confirm the association of diabetes and HbA1c with MoCA scores, an observation that has recently been described by others 8,17 . In contrast to diabetes, the relationship of HbA1c with neuroaxonal damage (NfL) and cognition (MoCA) did not remain significant after adjustment for vascular risk factors (ie, arterial hypertension, hypercholesterolemia, and prior stroke).…”

Section: Discussionsupporting

confidence: 90%

“…Previously, diabetes and increased HbAc1 were both associated with more severe motor impairment in PD 4,8 . Although there was a weak association of diabetes with H&Y stages, we did not observe this relationship with MDS‐UPDRS III in our study, which is likely due to the long disease duration and more advanced disease stages of PD patients in our study.…”

Section: Discussioncontrasting

confidence: 84%

“…However, we confirm the association of diabetes and HbA1c with MoCA scores, an observation that has recently been described by others. 8,17 In contrast to diabetes, the relationship of HbA1c with neuroaxonal damage (NfL) and cognition (MoCA) did not remain significant after adjustment for vascular risk factors (ie, arterial hypertension, hypercholesterolemia, and prior stroke). Nevertheless, we cannot completely rule out that the models of HbA1c were underpowered and underestimated the potential detrimental effects of hyperglycemia.…”

Section: Discussionmentioning

confidence: 91%

“…In addition to prevalent diabetes, recent studies suggested that hyperglycemia, that is glycated hemoglobin (HbA1c) ≥42 mmol/mol, is an independent predictor of faster motor progression determined by Hoehn & Yahr (H&Y) stage ≥3 or Movement Disorder Society‐Unified Parkinson's Disease Rating Scale Part III (MDS‐UPDRS III) >4 points 6,7 . In line with these findings, a cross‐sectional study revealed that high HbA1c levels in PD patients are associated with more severe motor impairment (MDS‐UPDRS III) 8 . Interestingly, interventional trials using antidiabetic drugs indicate that there might be a causal relationship between glycemic control and motor severity in PD patients 9 .…”

mentioning

confidence: 74%

“…6,7 In line with these findings, a cross-sectional study revealed that high HbA1c levels in PD patients are associated with more severe motor impairment (MDS-UPDRS III). 8 Interestingly, interventional trials using antidiabetic drugs indicate that there might be a causal relationship between glycemic control and motor severity in PD patients. 9 Here, we examined if prevalent diabetes and glycemic control (ie, HbA1c) in PD patients are associated with well-established markers of neuroaxonal damage (ie, serum neurofilament light chain [NfL]).…”

Section: Supporting Datamentioning

confidence: 99%

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Diabetes, Glycated Hemoglobin (HbA1c), and Neuroaxonal Damage in Parkinson's Disease (MARK‐PD Study)

et al. 2022

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Background Diabetes is associated with incidence and prevalence of Parkinson's disease (PD). Furthermore, glycated hemoglobin (HbA1c) levels have been linked with motor function and progression. Objectives We evaluated the relationship between prevalent diabetes and HbA1c levels with serum neurofilament light chain (NfL) levels as marker of neuroaxonal damage. Methods NfL concentrations were analyzed with Simoa in serum of 195 PD patients with available HbA1c values. Motor (MDS‐UPDRS III, Hoehn & Yahr [H&Y]) and cognitive (Montreal Cognitive Assessment [MoCA]) function was assessed and vascular comorbidities were documented from medical records. Results PD patients with prevalent diabetes had higher serum NfL levels and lower MoCA scores independent of age, body mass index (BMI), and vascular risk factors. Furthermore, diabetes was associated with higher H&Y stages in unadjusted and age/BMI‐adjusted models. Higher HbA1c levels were associated with increased NfL in unadjusted and age/BMI‐adjusted models. Conclusions In PD patients, diabetes and high HbA1c are associated with increased neuroaxonal damage and cognitive impairment. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 74%

Section: Supporting Datamentioning

confidence: 99%

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Diabetes, Glycated Hemoglobin (HbA1c), and Neuroaxonal Damage in Parkinson's Disease (MARK‐PD Study)

et al. 2022

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Glycated hemoglobin A1c, cerebral small vessel disease burden, and disease severity in Parkinson's disease

Ma,

Li,

Liu

et al. 2023

Ann Clin Transl Neurol

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ObjectiveOur study aimed to investigate the glucose levels in PD and controls. We also examine whether glucose control is associated with PD severity regardless of diabetic status, and test whether the correlation is mediated by cerebral small vessel disease (CSVD) burden.MethodsA total of 100 patients with idiopathic PD and 100 age‐ and sex‐matched controls who underwent brain magnetic resonance imaging (MRI) were enrolled in this study. We collected the clinical data and blood parameters, including fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c), and blood lipid. Patients with PD were divided into early (n = 61) and advanced (n = 39) subgroups, based on Hoehn and Yahr (H&Y) stages. Differences between the PD and controls, PD with and without diabetes, and between two PD subgroups were compared. CSVD markers were assessed, including lacunes, white matter hyperintensities, enlarged perivascular spaces, and cerebral microbleeds. Multivariable logistic regressions were used to test the association between HbA1c and H&Y stages. Interaction between HbA1c and CSVD burden in relation to H&Y stages was also analyzed.ResultsPD group exhibited higher HbA1c (p < 0.001), lower high‐density lipoprotein cholesterol (p < 0.001) and triglyceride (p = 0.049) than controls. Advanced PD patients showed higher HbA1c than early PD group (p = 0.022). Increasing HbA1c (OR = 1.54, 95% CI 1.03–2.32, p = 0.036) along with longer disease duration (OR = 1.14, 95% CI 1.01–1.27, p = 0.028) and higher UPDRS III score (OR = 1.07, 95% CI 1.02–1.11, p = 0.002) increased the risk of belonging to the higher H&Y stage. However, interaction between HbA1c and CSVD burden in relation to H&Y stages was not significant.InterpretationHbA1c is independently associated with H&Y stages in PD, and this correlation may not be mediated by CSVD burden.

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Parkinson’s Disease and Diabetes Mellitus: Synergistic Effects on Pathophysiology and GI Motility

Yan

Shimoga

Sharma

2023

Curr Gastroenterol Rep

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Parkinson's Disease and Type 2 Diabetes: HbA1c Is Associated with Motor and Cognitive Severity

Cited by 8 publications

References 9 publications

Diabetes, Glycated Hemoglobin (HbA1c), and Neuroaxonal Damage in Parkinson's Disease (MARK‐PD Study)

Diabetes, Glycated Hemoglobin (HbA1c), and Neuroaxonal Damage in Parkinson's Disease (MARK‐PD Study)

Glycated hemoglobin A1c, cerebral small vessel disease burden, and disease severity in Parkinson's disease

Parkinson’s Disease and Diabetes Mellitus: Synergistic Effects on Pathophysiology and GI Motility

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