Diabetes and risk of Parkinson's disease: an updated meta-analysis of case-control studies

PLoS One. 2014 Jan 21;9(1):e85781. doi: 10.1371/journal.pone.0085781. eCollection 2014.


Background: Whether diabetes increases the risk of Parkinson's disease (PD) is still inconclusive. The objective of this updated meta-analysis is to synthesize evidence from case-control studies that evaluated the association between diabetes and the risk of PD.

Methods: Seven databases were searched to identify case-control studies that evaluated the association between diabetes and PD. The methodological quality of included studies was assessed using Newcastle-Ottawa scale. All data were analyzed using Review Manager 5.1 software. Subgroup analyses were also adopted, according to stratification on gender, geographic location, source of the control group, smoking, anti-diabetes drug prescription and duration of DM.

Results: Fourteen studies fulfilled inclusion criteria for meta-analysis, yielding a total of 21395 PD patients and 84579 control subjects. Individuals with diabetes were found to have a negative association with future PD (OR 0.75; 95% CI 0.58-0.98) in spite of significant heterogeneity. In subgroup analyses, the negative correlation was still found in studies from North America, non-PD control groups from general population, never smoking individuals, and DM ascertainment based on questionnaire or self-report. Stratification of gender and DM duration showed no significant association. No association was also found in European and Asian individuals, hospital-based controls, ever smoking subjects, DM assessment by medical record or physician diagnosis, and insulin prescription for DM.

Conclusion: Evidence from case-control studies suggested that diabetic individuals may have a decreased incidence of PD despite significant heterogeneity. More researches are warranted to clarify an understanding of the association between diabetes and risk of PD.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Case-Control Studies
  • Diabetes Complications / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / etiology*
  • Publication Bias
  • Risk Factors

Grants and funding

This work is supported by the Xinmiao Planning Project of Science and Technology Department of Zhejiang Province (2008R40G2090034), Administration of Traditional Chinese Medicine of Zhejiang Province (2010ZQ010), and Project of Wenzhou Municipal Science and Technology Bureau in Zhejiang province (H20070044, Y20080145). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.