Clinical Analysis Of Parkinson's Disease Combined With Type 2 Diabetes

ObjectiveThe retrospective cohort study aims to analyze,summarize and better understand the clinical characteristics of patients with Parkinson's disease combined with type 2 diabetes.Try to find the possible pathophysiological mechanisms,and provide help for clinical diagnosis and treatment.Method105 patients with Parkinson's disease were enrolled in the outpatient clinic of Qilu Hospital,including 54 patients with type 2 diabetes(PD-T2DM group)and 51 patients without type 2 diabetes(PD-nT2DM group).Basic clinical data was collected,such as age,gender,mode of onset,age of onset,duration of disease,medication application,main symptoms,levodopa equivalent dose,etc.And the main clinical symptoms were comprehensively assessed by Movement Disorder Society-Sponsored Revision Unified Parkinson's Disease Rating Scale(MDS-UPDRS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Mini-mental State Exam(MMSE),Montreal Cognitive Assessment Scale(MoCA).Detailed cognitive function was evaluated randomly in some patients,by Fuld Object-Memory Evaluation(FOM),Verbal Fluency Test(FVT),Boston Naming Test(BNT),Trail Making Test(TMT),Stroop Color-Word Test(SCWT),Block Design Test(BD)and Digit Span(DS).A retrospective cohort study was performed on the data of the two groups,and the collected data was statistically analyzed using SPSS 22.0.Result1.Basic clinical data:The group of patients with Parkinson's disease combined with type 2 diabetes(PD-T2DM group)and the group of patients with Parkinson's disease not combined with type 2 diabetes(PD-nT2DM group)were not statistically different in gender,course of disease,body mass index((BMI),educational background,smoking history,drinking history,tea drinking history,coffee drinking history,and history of coronary heart disease.(p?0.05).Patients in the PD-T2DM group were older than the PD-nT2DM group,and the proportion of late-onset patients in the PD-T2DM group was higher(p<0.05).The PD-T2DM group was more likely to be combined with hypertension(p<0.05).2.Motor symptoms:There was no statistical difference between the PD-T2DM group and the PD-nT2DM group in the second and third parts of the UPDRS score,the bradykinesia sub-score,rigidity sub-score,gait disorder and abnormal posture sub-score(p?0.05).The score of tremor in PD-T2DM group was higher than that in PD-nT2DM group,and the proportion of tremor as the first symptom was greater than that in PD-nT2DM group(p<0.05).There were more type T in the PD-T2DM group,but more type PIGD in the PD-T2DM group(p<0.05).3.Non-motor symptoms:There was no significant difference between the PD-T2DM group and the PD-nT2DM group in the UPDRS Part I score,the Hamilton Anxiety Scale(HAMA)score,and the Hamilton Depression Scale(HAMD)score(p?0.05).There was no statistically significant difference in the incidence of remaining major non-motor symptoms,including hallucinations and psychiatric symptoms,depression,anxiety,apathy,nocturnal sleep disorders,excessive daytime sleepiness,abnormal urination,constipation,dizziness,and fatigue(p?0.05).4.Cognitive function:There was no significant difference in MMSE score between PD-T2DM group and PD-nT2DM group(p?0.05).The PD-T2DM group had lower MoCA scores,as well as naming,attention,and delayed recall scores,than the PD-nT2DM group(p<0.05).In the Stroop color word test(SCWT),the PD-T2DM group was worse than the PD-nT2DM group in the correct number of tests in group C and the correct number of interference tests(p<0.05).The scores of the Fuld Object Memory Test(FOM),Semantic Fluency Test(FVT),Boston Naming(BNT),Trajectory Test,Building Block Test,and Data Span Test were not statistically different(p?0.05).Conclusion1.The mean age of onset of Parkinson's disease combined with type 2 diabetes is older than that without type 2 diabetes.2.Most of the patients with Parkinson's disease combined with type 2 diabetes begin with the symptoms of tremor.And the symptom of tremor in the patients with type 2 diabetes is more severe than those without type 2 diabetes.3.Patients with Parkinson's disease combined with type 2 diabetes have more severe cognitive impairment than those not combined with type 2 diabetes,especially in the areas of attention,information processing ability,delayed recall and naming.