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Prediabetes, type 2 diabetes mellitus and risk of Parkinson’s disease: A population-based cohort study

  • Almudena Sánchez-Gómez
    Affiliations
    Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Spain

    Institut de Neurociències, Maeztu Center, University of Barcelona, Spain

    Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain

    Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED, CB06/05/0018-ISCIII), Barcelona, Spain
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  • Yesika Díaz
    Affiliations
    Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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  • Talita Duarte-Salles
    Affiliations
    Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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  • Yaroslau Compta
    Correspondence
    Corresponding author. Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
    Affiliations
    Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Spain

    Institut de Neurociències, Maeztu Center, University of Barcelona, Spain

    Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain

    Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED, CB06/05/0018-ISCIII), Barcelona, Spain
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  • Maria José Martí
    Correspondence
    Corresponding author. Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
    Affiliations
    Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Spain

    Institut de Neurociències, Maeztu Center, University of Barcelona, Spain

    Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain

    Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED, CB06/05/0018-ISCIII), Barcelona, Spain
    Search for articles by this author

      Highlights

      • Besides type-2-diabetes, prediabetes also increases the risk of Parkinson's disease .
      • The increased risk of both associations was greater in women and young individuals.

      Abstract

      Background

      Association of type 2 diabetes mellitus (T2D) with subsequent Parkinson's disease (PD) has supported the link between glucose metabolism and PD. We assessed the risk of PD not only in T2D but also in prediabetes.

      Methods

      We conducted a retrospective cohort study of the population attended in primary care centres of the Catalan Health Institute in Catalonia between 2006 and 2018. The data were obtained from the Information System for Research in Primary Care (SIDIAP). We created a cohort of T2D and prediabetes patients (HbA1c ≥ 5.7–6.4% without antidiabetic drugs or previous T2D diagnosis) and compared to a reference cohort. The outcome was PD diagnosis and we excluded PD before or during the first year of follow-up. We used multivariate Cox regression models to calculate hazard ratios (HR) and 95% confidence intervals (95%CI). We excluded subjects with atypical and secondary parkinsonisms.

      Results

      The exposed cohorts comprised of 281.153 patients with T2D and 266.379 with prediabetes and a reference cohort of 2.556.928 subjects. T2D and prediabetes were associated with higher risk of PD (HRadjusted 1.19, 95%CI 1.13–1.25, and 1.07, 1.00–1.14; respectively). In analyses stratified by sex, prediabetes was only associated with PD risk in women (1.12, 1.03–1.22 vs. 1.01, 0.99–1.10 in men). When analysis was stratified by age, T2D and prediabetes were associated with a greater PD risk both in women (2.36, 1.96–2.84 and 2.10, 1.70–2.59 respectively) and men (1.74, 1.52–2.00 and 1.90, 1.57–2.30 respectively) below 65 years-old.

      Conclusions

      We report for the first time that prediabetes increases the odds of subsequent PD and replicate the association with established T2D. Both associations predominate in women and young individuals.

      Keywords

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