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Diabetes mellitus and Parkinson disease.
- Source :
-
Neurology [Neurology] 2018 May 08; Vol. 90 (19), pp. e1654-e1662. Date of Electronic Publication: 2018 Apr 06. - Publication Year :
- 2018
-
Abstract
- Objective: To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease.<br />Methods: We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline.<br />Results: The presence of diabetes mellitus was associated with higher motor scores ( p < 0.01), lower striatal dopamine transporter binding ( p < 0.05), and higher tau CSF levels ( p < 0.05) in patients with Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding ( p < 0.05) and higher tau ( p < 0.05) and α-synuclein ( p < 0.05) CSF levels compared to healthy controls. At the Cox survival analysis in the population of patients with Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p < 0.01) and cognitive decline (hazard ratio = 9.314, 95% confidence interval = 1.164-74.519; p < 0.05).<br />Conclusions: Diabetes mellitus may predispose toward a Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype.<br /> (© 2018 American Academy of Neurology.)
- Subjects :
- Adult
Aged
Blood Glucose metabolism
Cognition Disorders etiology
Cross-Sectional Studies
Diabetes Complications blood
Diabetes Complications diagnostic imaging
Diabetes Complications epidemiology
Diabetes Mellitus blood
Diabetes Mellitus epidemiology
Disease Progression
Dopamine Plasma Membrane Transport Proteins metabolism
Female
Humans
Longitudinal Studies
Male
Middle Aged
Motor Disorders etiology
Parkinson Disease blood
Parkinson Disease diagnostic imaging
Parkinson Disease epidemiology
Tomography, Emission-Computed, Single-Photon
Tropanes metabolism
alpha-Synuclein cerebrospinal fluid
tau Proteins cerebrospinal fluid
Diabetes Complications complications
Diabetes Mellitus pathology
Diabetes Mellitus physiopathology
Parkinson Disease complications
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 90
- Issue :
- 19
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 29626177
- Full Text :
- https://doi.org/10.1212/WNL.0000000000005475