Type 2 Diabetes and the Risk of Parkinson's Disease

Abstract

OBJECTIVE -To evaluate whether type 2 diabetes at baseline is a risk factor for Parkinson's disease.RESEARCH DESIGN AND METHODS -We prospectively followed 51,552 Finnish men and women 25-74 years of age without a history of Parkinson's disease at baseline. History of diabetes and other study parameters were determined at baseline using standardized measurements. Ascertainment of the Parkinson's disease status was based on the nationwide Social Insurance Institution's drug register data. Hazard ratios of incident Parkinson's disease associated with the history of type 2 diabetes were estimated.RESULTS -During a mean follow-up period of 18.0 years, 324 men and 309 women developed incident Parkinson's disease. Age-and study year-adjusted hazard ratios of incident Parkinson's disease among subjects with type 2 diabetes, compared with those without it, were 1.80 (95% CI 1.03-3.15) in men, 1.93 (1.05-3.53) in women, and 1.85 (1.23-2.80) in men and women combined (adjusted also for sex). Further adjustment for BMI, systolic blood pressure, total cholesterol, education, leisure-time physical activity, smoking, alcohol drinking, and coffee and tea consumption affected the results only slightly. The multivariate adjusted association between type 2 diabetes and the risk of Parkinson's disease was also confirmed in stratified subgroup analysis.CONCLUSIONS -These data suggest that type 2 diabetes is associated with an increased risk of Parkinson's disease. Surveillance bias might account for higher rates in diabetes. The mechanism behind this association between diabetes and Parkinson's disease is not known. Diabetes Care 30:842-847, 2007T ype 2 diabetes is one of the fastest growing public health problems worldwide (1), and it is associated with multiple complications. Epidemiological studies have indicated that patients with type 2 diabetes present an excess risk of coronary heart disease compared with individuals without diabetes (2,3). Evidence from prospective epidemiological studies has identified type 2 diabetes as an independent risk factor for multiple hyperglycemia-induced complications virtually in all organs, including neurodegenerative diseases such as diabetic neuropathy (4), stroke (5-8), dementia (9 -11), and Alzheimer's disease (9 -11). However, little is known about the association between diabetes and the risk of Parkinson's disease. Only a few cross-sectional studies and two casecontrol studies have examined the prevalence of diabetes among patients with Parkinson's disease (12-15), and no prospective epidemiological studies have thus far addressed this association. Recently, animal and in vitro studies have shown that insulin dysregulation and changes in insulin action have been concerned in the pathophysiology and clinical symptoms of Parkinson's disease (16). The aim of this study was to examine whether type 2 diabetes at baseline is a risk factor for Parkinson's disease in a large population-based prospective cohort of Finnish men and women.RESEARCH DESIGN AND METHODS -Six independent crosssectional p...

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

“…A hospital-based case-control study [540] Several recent prospective studies examined the relation between diabetes and PD. Based on residents in five geographic areas in Finland, one large study reported higher risk of PD associated with diabetes assessed through a combination of self-report, hospital discharge information and prescription data (HR 1.85, 95% CI 1.22-2.79) [632]. Similarly, the Physicians Health Study observed increased risk of PD associated with self-reported diabetes (RR 1.34, 95% CI 1.01-1.77) [633].The association between diabetes and PD was modified by BMI (p for interaction 0.04); PD risk was decreased among individuals with both diabetes and high BMI.…”

“…Two large prospective studies reported increased PD risk associated with diabetes [632,633], one prospective study reported no association [634], whereas another reported lower risk of diabetes among PD cases [635]. Surveillance bias may cause a spurious positive association, an issue that may be of particular importance for a disease such as diabetes that can remain undetected during a long period of time.…”

Aging of perennial cells and organ parts according to the programmed aging paradigm

“…In aging, hyperglycemia is also associated with PD through damage to the central nervous system, a consequence of long-term exposure to glucose (Tomlinson and Gardiner 2008;Hu et al 2007). Epidemiologic studies suggest that previous type 2 diabetes is also a risk factor for developing PD (Mercer et al 2005).…”

Targeting AMPK for Therapeutic Intervention in Type 2 Diabetes

“…This is exemplified by renal nephropathy, myocardial disease, stroke, Alzheimer's and Parkinson's disease (Almdal et al, 2004;Biessels et al, 2006;Burdo et al, 2009;Hallows et al, 2010;Hu et al, 2007;Maher & Schubert, 2009;Schernhammer et al, 2011). Several drugs are currently used in the clinical setting to activate AMPK in patients suffering from type 2 diabetes or obesity.…”