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Research Paper|Volume 12, Issue 15|pp 15682—15704

Vascular, inflammatory and metabolic risk factors in relation to dementia in Parkinson’s disease patients with type 2 diabetes mellitus

Ting Wang1, Feilan Yuan1, Zhenze Chen1, Shuzhen Zhu1, Zihan Chang1, Wanlin Yang1, Bin Deng1, Rongfang Que1, Peihua Cao2, Yinxia Chao3, Lingling Chan3, Ying Pan4, Yanping Wang4, Linting Xu5, Qiurong Lyu6, Piu Chan7, Midori A. Yenari8, Eng-King Tan3, Qing Wang1
  • 1Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, P.R. China
  • 2Clinical Research Center, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, P.R. China
  • 3Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Duke-NUS Medical School, Singapore
  • 4Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
  • 5Department of Neurology, Puning People’s Hospital, Puning, Guangdong, China
  • 6Department of Neurology, Guiping People’s Hospital, Guangxi, China
  • 7Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
  • 8Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
* Equal contribution
Received: February 13, 2020Accepted: July 14, 2020Published: August 15, 2020
https://doi.org/10.18632/aging.103776

Copyright © 2020 Wang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

There are limited data on vascular, inflammatory, metabolic risk factors of dementia in Parkinson’s disease (PD) with type 2 diabetes mellitus (DM) (PD-DM). In a study of 928 subjects comprising of 215 PD with DM (including 31 PD-DM with dementia, PD-DMD), 341 PD without DM (including 31 PD with dementia, PDD) and 372 DM without PD (including 35 DM with dementia, DMD) patients, we investigated if vascular, inflammatory, metabolic, and magnetic resonance imaging (MRI) markers were associated with dementia in PD-DM. Lower fasting blood glucose (FBG<5mmol/L, OR=4.380; 95%CI: 1.748-10.975; p=0.002), higher homocysteine (HCY>15μmol/L, OR=3.131; 95%CI: 1.243-7.888; p=0.015) and hyperlipidemia (OR=3.075; 95%CI: 1.142-8.277; p=0.026), increased age (OR=1.043; 95%CI: 1.003-1.084; p=0.034) were the most significant risk factors in PDD patients. Lower low-density lipoprotein cholesterol (LDL-C<2mmol/L, OR=4.499; 95%CI: 1.568-12.909; p=0.005) and higher fibrinogen (>4g/L, OR=4.066; 95%CI: 1.467-11.274; p=0.007) were the most significant risk factors in PD-DMD patients. The area under the curve (AUC) for fibrinogen and LDL-C was 0.717 (P=0.001), with a sensitivity of 80.0% for the prediction of PD-DMD.

In summary, we identified several factors including LDL-C and fibrinogen as significant risk factors for PD-DMD and these may have prognostic and treatment implications.