PDF(Pubmed)
Abstract：
UNASSIGNED: Diabetes is associated with an increased risk of Parkinson\'s disease dementia (PDD); however, it is unknown whether this association is dependent on continuous hyperglycemia, hypoglycemic events, or glycemic variability. We aimed to investigate the relationship between visit-to-visit fasting glucose variability and PDD development in patients with Parkinson\'s disease (PD).
UNASSIGNED: Using data from the Korean National Health Insurance Service, we examined 9,264 patients aged ≥40 years with de novo Parkinson\'s disease (PD) who underwent ≥3 health examinations and were followed up until December 2019. Glucose variability was measured using the coefficient of variation, variability independent of the mean, and average real variability. Fine and Gray competing regression analysis was performed to determine the effect of glucose variability on incident PDD.
UNASSIGNED: During the 9.5-year follow-up period, 1,757 of 9,264 (19.0%) patients developed PDD. Patients with a higher visit-to-visit glucose variability had a higher risk of future PDD. In the multivariable adjusted model, patients with PD in the highest quartile (subdistribution hazard ratio [SHR] = 1.50, 95% CI 1.19 to 1.88), quartile 3 (SHR = 1.29, 95% CI 1.02 to 1.62), and quartile 2 (SHR = 1.30, 95% CI 1.04 to 1.63) were independently associated with a higher risk of PDD than those in the lowest quartile.
UNASSIGNED: We highlighted the effect of long-term glucose variability on the development of PDD in patients with PD. Furthermore, our findings suggest that preventive measures for constant glucose control may be necessary to prevent PDD.
UNASSIGNED: Using data from the Korean National Health Insurance Service, we examined 9,264 patients aged ≥40 years with de novo Parkinson\'s disease (PD) who underwent ≥3 health examinations and were followed up until December 2019. Glucose variability was measured using the coefficient of variation, variability independent of the mean, and average real variability. Fine and Gray competing regression analysis was performed to determine the effect of glucose variability on incident PDD.
UNASSIGNED: During the 9.5-year follow-up period, 1,757 of 9,264 (19.0%) patients developed PDD. Patients with a higher visit-to-visit glucose variability had a higher risk of future PDD. In the multivariable adjusted model, patients with PD in the highest quartile (subdistribution hazard ratio [SHR] = 1.50, 95% CI 1.19 to 1.88), quartile 3 (SHR = 1.29, 95% CI 1.02 to 1.62), and quartile 2 (SHR = 1.30, 95% CI 1.04 to 1.63) were independently associated with a higher risk of PDD than those in the lowest quartile.
UNASSIGNED: We highlighted the effect of long-term glucose variability on the development of PDD in patients with PD. Furthermore, our findings suggest that preventive measures for constant glucose control may be necessary to prevent PDD.
摘要：
■糖尿病与帕金森病痴呆（PDD）的风险增加有关；然而，尚不清楚这种关联是否依赖于持续的高血糖，低血糖事件,或血糖变异性。我们旨在研究帕金森病（PD）患者的访视空腹血糖变异性与PDD发展之间的关系。
■使用韩国国民健康保险服务的数据，我们检查了9,264例年龄≥40岁的新发帕金森病(PD)患者,这些患者接受了≥3次健康检查,随访至2019年12月.使用变异系数测量葡萄糖变异性，与平均值无关的变异性，和平均实际可变性。进行精细和灰色竞争回归分析以确定葡萄糖变异性对事件PDD的影响。
■在9.5年的随访期内，9,264例患者中有1,757例（19.0％）发生PDD。随访血糖变异性较高的患者未来发生PDD的风险较高。在多变量调整模型中，PD患者处于最高四分位数（亚分布风险比[SHR]=1.50，95%CI1.19至1.88），四分位数3(SHR=1.29，95%CI1.02至1.62)，与最低四分位数相比，四分位数2（SHR=1.30，95％CI1.04至1.63）与更高的PDD风险独立相关。
■我们强调了长期葡萄糖变异性对PD患者PDD发展的影响。此外，我们的研究结果表明,持续控制血糖的预防措施对于预防PDD可能是必要的.
■使用韩国国民健康保险服务的数据，我们检查了9,264例年龄≥40岁的新发帕金森病(PD)患者,这些患者接受了≥3次健康检查,随访至2019年12月.使用变异系数测量葡萄糖变异性，与平均值无关的变异性，和平均实际可变性。进行精细和灰色竞争回归分析以确定葡萄糖变异性对事件PDD的影响。
■在9.5年的随访期内，9,264例患者中有1,757例（19.0％）发生PDD。随访血糖变异性较高的患者未来发生PDD的风险较高。在多变量调整模型中，PD患者处于最高四分位数（亚分布风险比[SHR]=1.50，95%CI1.19至1.88），四分位数3(SHR=1.29，95%CI1.02至1.62)，与最低四分位数相比，四分位数2（SHR=1.30，95％CI1.04至1.63）与更高的PDD风险独立相关。
■我们强调了长期葡萄糖变异性对PD患者PDD发展的影响。此外，我们的研究结果表明,持续控制血糖的预防措施对于预防PDD可能是必要的.
