Correlation Between Diabetes Mellitus And Other Factors And Parkinson's Disease

BackgroundParkinson's disease(Parkinson's disease,PD)is a common neurodegenerative disease.Its main pathological change is the gradual degeneration of dopaminergic neurons in the mesencephalic substantia nigra and the decrease of dopamine(Dopaminge,DA)in the striatum,which accompanied by the activation and proliferation of glial cells.The clinical symptoms of Parkinson's disease mainly include motor symptoms and non motor symptoms,which include static tremor,myotonic rigidity,motion retardation,postural balance disorder,hypothyroidism,abnormal sleep behavior,constipation and anxiety and depression.With the development of the disease,the movement symptoms and non movement of Parkinson's disease are becoming more and more serious.At the late stage of disease,parkinson disease is complicate which include the reduction of drug effect,the "opening-off" phenomenon,the dyskinesia and so on.For Parkinson's disease,the present stage of treatment still depend on "dopamine",dopamine receptor agonist,anticholinergic drugs and other alternative or symptomatic treatment,which can relieve the symptoms of Parkinson's disease,but can not prevent the progress of Parkinson's disease and neurodegenerative changes.The patients who developed to the late disease often suffer from symptoms such as gait freezing,balance barrier,dysphagia,extreme slow movement and speech,resulting in a serious decline in the quality of life,a heavy burden on individuals and families,and a far-reaching impact on social development.The incidence of Parkinson's disease in China over 65 yearsold is 1 700/10 000,and the incidence increases with age.At present,China is in the long-term and will be in an aging society.Therefore,the prevention and treatment of Parkinson's disease is imminent.Finding and controlling the risk factors of Parkinson's disease is the key to prevent Parkinson's disease.At present,the mainstream view is that the incidence of Parkinson's disease is related to many factors,such as age,environmental factors,genetic factors,immune factors and so on.Recent studies have found that Parkinson's disease is also associated with diabetes.Diabetes mellitus(DM)is the most common complex metabolic disease in China.In the past 30 years,the prevalence of diabetes in China has increased significantly.In2008,the prevalence rate of diabetes in China was about 9.7%.Although it was lower than the incidence of disease in developed countries in Europe and America,but because of the large population base in China,China has become the largest number of diabetic patients all over the world.Insulin resistance(IR)is one of the main pathogenesis of diabetes.It refers to the decrease of insulin mediated glucose metabolism,that is,the cytological effect of insulin in unit concentration is weakened,the target organs of insulin action,such as liver,adipose tissue and muscle tissue,are less sensitive to insulin.Compensatory insulin secretion is increased,which resulted in hyperinsulinemia.In the past,it is believed that Parkinson's disease and diabetes are independent,but domestic and foreign epidemiological studies have found that diabetes and nervous system degenerative diseases,especially with Parkinson's disease,often accompany in recent years.Further laboratory studies have found that there are common pathophysiological mechanisms between the two diseases,such as insulin resistance,mitochondrial dysfunction and oxidative stress,neuroinflammatory response,vitamin D deficiency,and changes in insulin signaling pathways leading to downstream cell dysfunction.At present,there is a lot of evidence that diabetes may be a risk factor for Parkinson's disease,which may aggravate the symptoms of Parkinson's disease,which is mainly to aggravate the symptoms of Parkinson's disease.ObjectiveThe current treatment of Parkinson's disease is still mainly based on dopamine and dopamine receptor agonists,which can alleviate the symptoms of Parkinson's disease,but it can't prevent the progression and degeneration of PD.The purpose of this study is to investigate the relationship between type 2 diabetes mellitus andParkinson's disease and verify whether DM is a risk factor for PD,and to explore whether there is a correlation between insulin resistance and severity of Parkinson's disease.So as to explore new ideas for the prevention and treatment of Parkinson disease.Materials and MethodsA total of 217 cases of Parkinson's disease were diagnosed in our department from April 2016 to April 2018 and choose randomly 217 cases of non Parkinson's disease at the same time,which is used for clinical correlation analysis.Records of patients' age,sex,diabetes,hypertension,hyperthyroidism,drinking thick tea,alcohol,smoking,education,total cholesterol,low density lipoprotein cholesterol,triglycerides,blood uric acid,contact history of industrial poison,history of brain trauma,positive family history,birthplace,residence,blood identical half Cystine,depression,and BMI.Single factor correlation analysis and unconditional logistic regression analysis were used to verify the risk factors of Parkinson's disease.At the same time,the fasting blood glucose and fasting insulin were measured in Parkinson patients.The HOMA-IR score was calculated,which was used for determined the degree of insulin resistance.And record the exercise score of UPDRS.Explore the correlation between the degree of insulin resistance and motor symptoms in Parkinson patients.Results1.a total of 217 people in the case of Parkinson's disease and the control group were investigated.Among them,there were 126 men(58.1%)in the Parkinson's disease group,91 in women(41.9%),116 in the control group(53.5%)and 101 in women(46.5%);the age of Parkinson's disease was 37~84 years,and the average age was 65 years,and the control group was 32~89 years old,The average age is 62 years.All samples were obtained from Department of Neurology,the Second Affiliated Hospital of Guangzhou Medical University2.A single factor analysis of Parkinson's and non Parkinson's disease showed that there was a correlation between age,diabetes,triglyceride,smoking and the incidence of Parkinson's disease(P<0.05).3.A single factor analysis of the cases of Parkinson's disease and non Parkinson's disease,suggesting that sex,hypertension,hyperthyroidism,drinking thick tea,alcohol,cultural degree,total cholesterol,low density lipoprotein cholesterol,hyperuricemia,industrial poison contact,brain trauma,positive familyhistory,birthplace,and residence Hyperhomocysteinemia,history of depression,BMI were not correlated with Parkinson's disease(P>0.05).4.4 factors including age,diabetes,triglyceride and smoking were bringed into the unconditional logistic regression analysis of Parkinson's disease and non Parkinson's disease,suggesting a positive correlation between age,diabetes and the incidence of Parkinson's disease.Among them,the risk of Parkinson's disease in diabetics is 1.736 times that of patients without diabetes.Triglyceride and smoking were negatively correlated with the incidence of Parkinson's disease.5.The patients who had detected fasting insulin and fasting blood glucose in the Parkinson's disease group were divided into high insulin resistance group and low insulin resistance group according to the degree of insulin resistance.The difference between the two groups of UPDRS movement scores was compared,suggesting that the level of insulin resistance is associated with the severity of Parkinson's disease.P<0.05.Conclusions1.age,diabetes,triglycerides,smoking are associated with the incidence of Parkinson's disease.2,.sex,high blood pressure,drinking thick tea,alcohol,total cholesterol,low density lipoprotein cholesterol,hyperuricemia,industrial poison contact,brain trauma,positive family history,birthplace,residence,hyperhomocysteinemia,and the relationship with Parkinson's disease need to be further studied.3.Hyperthyroidism,education level,history of depression,BMI are not associated with Parkinson's disease.4.Age and diabetes are independent risk factors for Parkinson's disease.Hypertriglyceridemia and smoking are protective factors for Parkinson's disease.5.There is a correlation between the degree of insulin resistance and the severity of Parkinson's disease,which is related to postural balance,static tremor and no correlation with myotonic rigidity.