期刊
EUROPEAN JOURNAL OF NEUROLOGY
卷 28, 期 2, 页码 430-437出版社
WILEY
DOI: 10.1111/ene.14542
关键词
diabetes mellitus; Parkinson disease; pioglitazone; statin
资金
- Kaohsiung Medical University Hospital [KMUH 98-8R43]
- Kaohsiung Municipal Ta-Tung Hospital [KMTTH-107-013]
- Ministry of Science and Technology [106-2314-B-037-057]
The study suggests that pioglitazone may reduce the incidence of Parkinson's disease in patients with diabetes mellitus and works synergistically with statins.
Background and purpose The pharmacologic effects of pioglitazone on the incidence of Parkinson disease (PD) are not clear. No study has examined the interaction between pioglitazone and statin treatment on prevention of PD. This study analyzed the associations between pioglitazone, statins, and the incidence of PD in patients with diabetes mellitus (DM) in Taiwan. Methods We used the National Health Insurance database from 1996 to 2013. DM and PD were diagnosed according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used the propensity score-matching method to match the study groups. Cox regression analyses were employed to calculate the relative risk of the incidence of PD. Results There were 48 828 patients matched and categorized equally into the pioglitazone group and the non-pioglitazone group. The number of PD patients in the pioglitazone group and the non-pioglitazone group was 275 (1.1%) and 417 (1.7%), respectively. The pioglitazone group had a lower incidence of PD, with an adjusted hazard ratio (aHR) of 0.66 [95% confidence interval (CI): 0.57-0.78], and this benefit was dose-dependent. Of note, as compared with either pioglitazone or statin treatment, our results first showed that the combination of pioglitazone and statins further lowered the risk of PD, with an aHR of 0.78 (95% CI: 0.64-0.94; P = 0.010). Conclusions Our study results suggested that pioglitazone could be a promising agent for reducing the incidence of PD in patients with DM, and works synergistically with statins.
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