Association of Dynamic Changes in Metabolic Syndrome Status with the Risk of Parkinson’s Disease: A Nationwide Cohort Study

Article type: Research Article

Authors: Park, Sang Hyun^a | Nam, Ga Eun^{b; 1; *} | Han, Kyungdo^c | Huh, Youn^d | Kim, Wonsock^d | Lee, Min-Kyung^e | Koh, Eun-Sil^f | Kim, Eun Sook^g | Kim, Mee Kyung^h | Kwon, Hyuk-Sang^h | Kim, Seon Mee^b | Cho, Kyung Hwan^b | Park, Yong Gyu^{i; 1; *}

Affiliations: [a] Department of Biomedicine & Health Science, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea | [b] Department of Family Medicine, Korea University College of Medicine, Seoul, Republic of Korea | [c] Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea | [d] Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji Unversity, Gyeonggi-do, Republic of Korea | [e] Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea | [f] Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea | [g] Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea | [h] Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea | [i] Department of Medical Lifescience, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: Ga Eun Nam, Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea. Tel.: +82 2 920 5104; Fax: +82 2 928 8083; E-mail: [email protected] and Yong Gyu Park, Department of Medical Lifescience, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. Tel.: +82 2 2258 7226; Fax: +82 2 928 8083; E-mail: [email protected].

Note: [1] These authors contributed equally to this work.

Abstract: Background:The longitudinal association between dynamic changes in the metabolic syndrome (MS) status and Parkinson’s disease (PD) has been poorly studied. Objective:We examined whether dynamic changes in MS status are associated with altered risk for PD. Methods:This study was a nationwide retrospective cohort study. We enrolled 5,522,813 individuals aged≥40 years who had undergone health examinations under the National Health Insurance Service between 2009 and 2010 (two health examinations with a 2-year interval). Participants were followed up until the end of 2017. The participants were categorized into four groups according to MS status changes over 2 years: non-MS, improved MS, incident MS, and persistent MS groups. Multivariable Cox hazard regression was performed. Results:During the 7-year median follow-up, there were 20,524 cases of newly developed PD. Compared with non-MS group, improved, incident, and persistent MS groups for 2 years were significantly associated with higher risks of PD (model 3; hazard ratio: 1.12, 95%confidence interval: 1.06–1.19 [improved MS]; 1.15, 1.09–1.22 [incident MS]; and 1.25, 1.20–1.30 [persistent MS]). Individuals with incident and persistent abdominal obesity, low levels of high-density lipoprotein cholesterol, hypertriglyceridemia, and hyperglycemia had a significantly increased risks of PD compared with those without either condition over 2 years. Conclusion:Persistent and incident MS and its components may be risk factors for incident PD. Ever exposure to MS may also be associated with PD risk. Appropriate intervention for preventing and improving MS may be crucial in decreasing the PD incidence.

Keywords: Metabolic syndrome, Parkinson’s disease, metabolic change, cohort

DOI: 10.3233/JPD-212589

Journal: Journal of Parkinson's Disease, vol. 11, no. 4, pp. 1751-1759, 2021