Background — Athough an association exists between type 2 diabetes and Parkinson’s disease (PD), the implications of glycemic variability on PD are unknown. We assessed the future risk of incident PD according to visit-to-visit fasting plasma glucose (FPG) variability; this was calculated using standard deviation (FPG-SD), coefficient variance (FPG-CV), and variability independent of the mean (FPG-VIM).
Methods — Using the Korean National Health Insurance Service–Health Screening Cohort, we followed 131,625 Korean adults without diabetes. This study population was divided into a midlife group (<65 years) and an elderly group (≥65 years), during a median follow-up of 8.4 years.
Results — The adjusted hazard ratios (HRs) were calculated using a multivariable Cox proportional hazard analysis. In the midlife group, the HRs for incident PD in the highest quartile of FPG variability, as measured using SD, CV, and VIM, were 1.35 (95% confidence interval (CI), 1.07–1.70), 1.31 (95% CI, 1.04–1.65), and 1.33 (95% CI, 1.06–1.67), respectively, when compared to the lowest quartile group. However, the incident PD was not different depending on FPG variability in the elderly group. Kaplan–Meier curves of PD probability showed a progressively increasing risk of PD according to the higher FPG variability in the midlife group. According to a multivariable adjusted model, a 1-SD unit increment in glycemic variability was associated with a 9% higher risk for incident PD in the midlife group.
Conclusions — Increased long-term glycemic variability is a preceding risk factor for developing PD in the midlife population without diabetes.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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Posted 02 Mar, 2020
Posted 02 Mar, 2020
Background — Athough an association exists between type 2 diabetes and Parkinson’s disease (PD), the implications of glycemic variability on PD are unknown. We assessed the future risk of incident PD according to visit-to-visit fasting plasma glucose (FPG) variability; this was calculated using standard deviation (FPG-SD), coefficient variance (FPG-CV), and variability independent of the mean (FPG-VIM).
Methods — Using the Korean National Health Insurance Service–Health Screening Cohort, we followed 131,625 Korean adults without diabetes. This study population was divided into a midlife group (<65 years) and an elderly group (≥65 years), during a median follow-up of 8.4 years.
Results — The adjusted hazard ratios (HRs) were calculated using a multivariable Cox proportional hazard analysis. In the midlife group, the HRs for incident PD in the highest quartile of FPG variability, as measured using SD, CV, and VIM, were 1.35 (95% confidence interval (CI), 1.07–1.70), 1.31 (95% CI, 1.04–1.65), and 1.33 (95% CI, 1.06–1.67), respectively, when compared to the lowest quartile group. However, the incident PD was not different depending on FPG variability in the elderly group. Kaplan–Meier curves of PD probability showed a progressively increasing risk of PD according to the higher FPG variability in the midlife group. According to a multivariable adjusted model, a 1-SD unit increment in glycemic variability was associated with a 9% higher risk for incident PD in the midlife group.
Conclusions — Increased long-term glycemic variability is a preceding risk factor for developing PD in the midlife population without diabetes.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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