Association between diabetes and subsequent Parkinson disease: A record-linkage cohort study

Neurology. 2018 Jul 10;91(2):e139-e142. doi: 10.1212/WNL.0000000000005771. Epub 2018 Jun 13.

Abstract

Objective: To investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD).

Methods: Linked English national Hospital Episode Statistics and mortality data (1999-2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort. Subsequent PD risk was estimated using Cox regression models. Individuals with a coded diagnosis of cerebrovascular disease, vascular parkinsonism, drug-induced parkinsonism, and normal pressure hydrocephalus were excluded from the analysis.

Results: A total of 2,017,115 individuals entered the T2DM cohort and 6,173,208 entered the reference cohort. There were significantly elevated rates of PD following T2DM (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.29-1.35; p < 0.001). The relative increase was greater in those with complicated T2DM (HR 1.49, 95% CI 1.42-1.56) and when comparing younger individuals (HR 3.81, 95% CI 2.84-5.11 in age group 25-44 years).

Conclusions: We report an increased rate of subsequent PD following T2DM in this large cohort study. These findings may reflect shared genetic predisposition and/or disrupted shared pathogenic pathways with potential clinical and therapeutic implications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology*
  • England / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / epidemiology*
  • Retrospective Studies
  • Risk Factors