Risk of Parkinson’s Disease in Patients with Type 2 Diabetes Mellitus and Other Comorbidities: A 5-Year Population-Based Cohort Study in Taiwan

糖尿病病人及有其他併發症病人之帕金森氏症風險：臺灣人群基礎的五年世代研究

李佳儒(Chia-Ju Lee) ； 葉懿諄(Yi-Chun Yeh) ； 梁均瑜(Chun-Yu Liang) ； 陳彥宇(Yen-Yu Chen)

《The Changhua Journal of Medicine》 15卷3期 (2017/09) Pp. 128-137

https://doi.org/10.6501/CJM.1503.002

摘要

The aim of this study was to determine whether type 2 diabetes mellitus (DM) and other comorbidities increase the risk of developing Parkinson's disease (PD). We conducted a retrospective cohort study using the National Health Insurance Research Database of Taiwan between 1999 and 2003. All patients were followed-up for up to five years, until lost to follow-up or a PD-related event. Each subject with type 2 DM was randomly matched with two non-diabetic subjects by age and gender. The Cox's proportional hazard model was used to evaluate the risk of future development of PD. A total of 24,885 patients with type 2 DM and 49,770 age- and sex- matched non- diabetic subjects were included in the study. After adjustment of confounding factors, type 2 DM was associated with a 39% higher future risk of PD (HR: 1.39 [CI: 1.15 ～ 1.68]). The risk was greater in patients with pre ～ existing diabetes (HR: 1.72 [CI: 1.37 ～ 2.16]), older people (HR: 1.36 [CI: 1.12 ～ 1.67]), and female subjects (HR: 1.47 [CI: 1.13 ～ 1.90]). Patients with hypertension, ischemic heart disease (IHD), and episodic mood disorders also had significantly higher risks of PD (HR: 1.55 [CI: 1.29 ～ 1.88], HR: 1.47 [CI: 1.19 ～ 1.81], and HR: 4.25 [CI: 3.04 ～ 5.94], respectively). The study results showed that type 2 DM, as well as hypertension, IHD, and episodic mood disorders, are associated with an increased risk of PD in the population of Taiwan.

關鍵字

Diabetes Mellitus ； Parkinson's disease ； Taiwan

並列摘要

本篇研究之目的是了解糖尿病病人及有其他併發症病人增加得到帕金森氏症的風險。藉由1999年至2003年間的臺灣健康保險資料庫作回溯性世代研究。所有的病人都追蹤至五年、無法追蹤或發生帕金森氏症相關症狀為止。每個第二型糖尿病病人皆與兩位年紀和性別相符之非糖尿病病人配對。利用Cox比例風險模式來評估發展至帕金森氏症的風險。此研究一共蒐集了24,885位糖尿病病人以及49,770位配對之非糖尿病病人。校正混擾因子後，第二型糖尿病相關連於增加了39%未來發展成帕金森氏症的風險；尤其是既有糖尿病之病人、老年人和女性。此外，病人如有高血壓、缺血性心臟病和陣發性情緒疾患，亦顯著地有較高的帕金森氏症風險。此研究顯示：臺灣人口中，第二型糖尿病、高血壓、缺血性心臟病和陣發性情緒疾患的病人有較高的帕金森氏症風險。

並列關鍵字

帕金森氏症 ； 糖尿病 ； 臺灣