Parkinsonism & related disorders · 2025
Impact of dipeptidyl peptidase 4 inhibitor use on mortality in diabetic Parkinson's disease patients: A nationwide cohort study.
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Park Mincheol, Lee Ho Kyung, Jin Yeonju, Yoo Sanghee, Kim Sung-Woo, Park Sojeong, Hong Jiwon, Hong Jin Yong, Hong Ickpyo, Baek Min Seok
Аннотация
BACKGROUND: Dipeptidyl peptidase-4 inhibitors (DPP4i) are commonly used oral hypoglycemic agents that enhance the bioavailability of active glucagon-like peptide-1 by inhibiting its degradation. Recent studies suggest possible neuroprotective effects of DPP4i in Parkinson's disease (PD); however, their association with mortality in PD is unclear.
METHODS: This retrospective cohort study analyzed the Korean National Health Insurance Service database. The cohort included 1093 adults diagnosed with both PD and type 2 diabetes (DM) between 2009 and 2019. We divided the participants into two groups: those not receiving DPP4i (PD-DPP4i+, n = 557) and those treated with DPP4i (PD-DPP4i-, n = 536). We used Kaplan-Meier survival analyses and Cox proportional hazard models to evaluate survival rates. Cox regression models included age, sex, number of comorbidities, and end-organ complication of DM including diabetic neuropathy and retinopathy as covariates.
RESULTS: The average age of the study participants was 73.40 (±7.67) years, and the majority were female (n = 674, 61.67 %). Kaplan-Meier analysis revealed the lower risk of mortality in the PD-DPP4i+ group (p < 0.0001). The Cox proportional hazards regression model indicated that PD-DPP4i+ group had a lower risk of death compared to PD-DPP4i- group (hazard ratio, 0.762; 95 % confidence interval, 0.611-0.949; p = 0.0153). Factors including male sex, older age at PD diagnosis, and the presence of more than two comorbidities were associated with an increased risk of death.
CONCLUSIONS: These findings suggest that the use of DPP4i in PD patients with co-existing DM is associated with lower risk of mortality.
METHODS: This retrospective cohort study analyzed the Korean National Health Insurance Service database. The cohort included 1093 adults diagnosed with both PD and type 2 diabetes (DM) between 2009 and 2019. We divided the participants into two groups: those not receiving DPP4i (PD-DPP4i+, n = 557) and those treated with DPP4i (PD-DPP4i-, n = 536). We used Kaplan-Meier survival analyses and Cox proportional hazard models to evaluate survival rates. Cox regression models included age, sex, number of comorbidities, and end-organ complication of DM including diabetic neuropathy and retinopathy as covariates.
RESULTS: The average age of the study participants was 73.40 (±7.67) years, and the majority were female (n = 674, 61.67 %). Kaplan-Meier analysis revealed the lower risk of mortality in the PD-DPP4i+ group (p < 0.0001). The Cox proportional hazards regression model indicated that PD-DPP4i+ group had a lower risk of death compared to PD-DPP4i- group (hazard ratio, 0.762; 95 % confidence interval, 0.611-0.949; p = 0.0153). Factors including male sex, older age at PD diagnosis, and the presence of more than two comorbidities were associated with an increased risk of death.
CONCLUSIONS: These findings suggest that the use of DPP4i in PD patients with co-existing DM is associated with lower risk of mortality.