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Diabetes, Parkinson’s disease may share genetic, pathogenic links
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The risk for a later-in-life Parkinson’s disease diagnosis may be increased for patients with type 2 diabetes, according to a study published in Neurology.
“We can now say more definitely that there is a link between diabetes and Parkinson’s, but we need to do more research to understand the relationship — whether it’s due to genetics, the effect of diabetes on the brain or, probably, both,” Thomas T. Warner, FRCP, PhD, professor of clinical neurology, Institute of Neurology, University College London, told Endocrine Today. “It will also help developing new ways to treat or prevent the development of Parkinson’s disease, such as use of antidiabetes drugs to restore the brain’s insulin signaling. A UCL-led study published last year found that a drug commonly used to treat diabetes shows promise in not only relieving Parkinson’s symptoms, but potentially altering the course of the disease itself.”
Warner and colleagues conducted a retrospective cohort study using linked national Hospital Episode Statistics and mortality data from U.K. adults collected from 1999 to 2011. A type 2 diabetes cohort of 2,017,115 adults was identified by a first hospital admission in which type 2 diabetes was recorded (1,068,269 men; 948,846 women). The cohort was further divided into four groups by age: 25 to 44 years (n = 130,728), 45 to 64 years (n = 650,387), 65 to 74 years (n = 571,291) or at least 75 years (n = 664,709). A reference cohort of 6,173,208 patients without diabetes who had been admitted to the hospital for minor medical and surgical procedures served as a comparator group. Researchers used multivariable Cox proportional hazard regression models to estimate the risk for a future diagnosis of Parkinson’s disease.
After adjusting for age, sex, calendar year of cohort entry, region of residence and patients’ quintile of Index of Multiple Deprivation score, researchers found that the rate of a subsequent Parkinson’s disease diagnosis was 32% higher in the type 2 diabetes cohort than the reference cohort (14,252 of 2,017,115 vs. 20,878 of 6,173,208; HR = 1.32; 95% CI, 1.29-1.35). In addition, results showed a 49% greater risk for Parkinson’s disease among patients who experienced complications because of their type 2 diabetes vs. those without diabetes (HR = 1.49; 95% CI, 1.42-1.56). Patients with type 2 diabetes without complications were 30% more likely to develop Parkinson’s disease than those without (HR = 1.3; 95% CI, 1.27-1.33).
Age of patients with diabetes was also associated with a Parkinson’s disease diagnosis, with younger adults at greater risk. In the subgroup aged 25 to 44 years, 58 of 130,728 patients with diabetes developed Parkinson’s disease compared with 280 of the 2,559,693 without diabetes (HR = 3.81; 95% CI, 2.84-5.11). The HRs for adults with diabetes aged 45 to 64 years, 65 to 74 years and at least 75 years were 1.71,1.4 and 1.18, respectively.
Women with type 2 diabetes had a greater risk for developing Parkinson’s disease (HR = 1.42; 95% CI, 1.37-1.47) than men with diabetes (HR = 1.42; 95% CI, 1.23-1.3).
“We need to understand how type 2 diabetes increases the risk of later developing Parkinson’s disease and causes problems with parts of the brain that control movement, and whether improving insulin signaling in the brain will treat or slow down progression of this neurodegenerative disorder,” Warner said. “To date there is no evidence that Parkinson’s disease gives an increased risk of diabetes.” – by Melissa J. Webb
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Thomas T. Warner, FRCP, PhD, can be reached at t.warner@ucl.ac.uk.
Disclosures: The study was funded by the NIHR Biomedical Research Centre, Oxford, and NIHR Biomedical Research Center, University College London. Warner reports he is funded by UCL and that he has received grants from Cure Huntington’s Disease Initiative, CBD Solutions Inc., Medical Research Council and Reta Lila Weston Medical Trust. He has received Honoraria from Britannia Pharmaceuticals and Teva. Please see full study for all other authors’ relevant financial disclosures.
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