Glucagon-Like Peptide-1 Receptor Agonists and Risk of Parkinson's Disease in Patients with Type 2 Diabetes: A Population-Based Cohort Study

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2024-08-27 DOI:10.1002/mds.29992

Huilin Tang MSc, Ying Lu BA, Michael S. Okun MD, William T. Donahoo MD, Adolfo Ramirez-Zamora MD, Fei Wang PhD, Yu Huang PhD, Melissa Armstrong MD, MSc, Mikael Svensson PhD, Beth A. Virnig PhD, MPH, Steven T. DeKosky MD, Jiang Bian PhD, Jingchuan Guo MD, PhD

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Abstract

Background

Previous studies have suggested that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may have a disease-modifying effect in the development of Parkinson's disease (PD), but population studies yielded inconsistent results.

Objective

The aim was to compare the risk of PD associated with GLP-1RAs compared to dipeptidyl peptidase 4 inhibitors (DPP4i) among older adults with type 2 diabetes (T2D).

Methods

Using U.S. Medicare administrative data from 2016 to 2020, we conducted a population-based cohort study comparing the new use of GLP-1RA with the new use of DPP4i among adults aged ≥66 years with T2D. The primary endpoint was a new diagnosis of PD. A stabilized inverse probability of treatment weighting (sIPTW)–adjusted Cox proportional hazards regression model was employed to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for PD between GLP-1RA and DPP4i users.

Results

This study included 89,074 Medicare beneficiaries who initiated either GLP-1RA (n = 30,091) or DPP4i (n = 58,983). The crude incidence rate of PD was lower among GLP-1RA users than DPP4i users (2.85 vs. 3.92 patients per 1000 person-years). An sIPTW-adjusted Cox model showed that GLP-1RA users were associated with a 23% lower risk of PD than DPP4i users (HR, 0.77; 95% CI, 0.63–0.95). Our findings were largely consistent across different subgroup analyses such as sex, race, and molecular structure of GLP-1RA.

Conclusion

Among Medicare beneficiaries with T2D, the new use of GLP-1RAs was significantly associated with a decreased risk of PD compared to the new use of DPP4i. © 2024 International Parkinson and Movement Disorder Society.

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胰高血糖素样肽-1 受体激动剂与 2 型糖尿病患者罹患帕金森病的风险：一项基于人群的队列研究。

背景：以前的研究表明，胰高血糖素样肽-1受体激动剂（GLP-1RAs）可能对帕金森病（PD）的发展具有疾病调节作用，但人群研究的结果并不一致：目的：在患有 2 型糖尿病（T2D）的老年人中，比较 GLP-1RA 与二肽基肽酶 4 抑制剂（DPP4i）相关的帕金森病风险：利用 2016 年至 2020 年的美国医疗保险管理数据，我们开展了一项基于人群的队列研究，比较了年龄≥66 岁的 2 型糖尿病成人中新使用 GLP-1RA 与新使用 DPP4i 的情况。研究的主要终点是新诊断为帕金森病。采用稳定的逆治疗概率加权（sIPTW）调整后的考克斯比例危险回归模型来估计GLP-1RA和DPP4i使用者之间PD的危险比（HR）和95%置信区间（CI）：该研究纳入了 89,074 名开始使用 GLP-1RA （30,091 人）或 DPP4i （58,983 人）的医疗保险受益人。GLP-1RA使用者的PD粗发病率低于DPP4i使用者（每千人年2.85例 vs. 3.92例）。经 sIPTW 调整的 Cox 模型显示，GLP-1RA 使用者罹患 PD 的风险比 DPP4i 使用者低 23%（HR，0.77；95% CI，0.63-0.95）。我们的研究结果在不同的亚组分析中基本一致，如性别、种族和GLP-1RA的分子结构：结论：在患有 T2D 的医疗保险受益人中，与新使用 DPP4i 相比，新使用 GLP-1RA 与帕金森病风险的降低有显著相关性。© 2024 国际帕金森病和运动障碍协会。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.