Objective: To study the state of lipid metabolism in PD patients with concomitant type 2diabetes (with different glucose tolerance and the effect of DA agonist bromocriptin on the clinical features of the disease course).

Background: Parkinson’s disease (PD) is widespread around the globe. Impacts of diabetes mellitus on PD are non-clear and non-evaluated.

Methods: 54 patients with PD at the age of 43-58 years with the disease stage of 1.5-3.0 by Hoehn and Yahr were examined.35 patients received bromocriptine at a dose of 7.5 mg / day for 25 days with antiparkinsonian therapy.Patients were divided into three groups: group I – normal glucose tolerance (n = 25), group II – impaired glucose tolerance (NTG) (n = 12), group III – concomitant type 2 diabetes (n = 19).The control group (CG) included 20 healthy persons of the corresponding age.All patients were assessed glucose (fasting and after load),the lipid spectrum.

Results: Treatment with bromocriptine contributes to a significant improvement in lipid metabolism, especially in patients with ІІ and ІІІ groups. Thus, the level of total cholesterol decreased by 10.9% in the ІІ group and by 12.3% in the ІІІ group. Patients with PD with concomitant type 2 diabetes had more pronounced manifestations of the main parkinsonian triad (akinesia-rigidity-tremor) and postural disorderds. All patients with PD who received course treatment with bromocriptine significantly improved their clinical symptoms. In Igroup daytime activity increased from 71.7 ± 1.3 to 80.5 ± 1.3% (p <0.05), the total motor rating decreased by 20.8% - from 38.4 ± 1 , 96 to 30.4 ± 1.8 points (p <0.001).In II group after bromocriptine treatment daily activity increased from 70.5 ± 1.3 to 78.0 ± 1.1% (p <0.001), the total motor rating decreased by 19.8% - from 39.4 ± 2.1 to 31.6 ± 2.08 points (p <0.001).For III group a significant improvement in the clinical manifestations of PD was also characteristic. They observed an increase in daily activity from 71.0 ± 1.7 to 78.0 ± 1.3% (p <0.01), the total motor score decreased by 21.8% - from 41.2 ± 2.1 up to 32.6 ± 1.9 points (p <0.001).

Conclusions: In PD, there is a decrease in glucose tolerance, combined with dyslipoproteinemia, especially in patients PD with concomitant type 2 diabetes, which indicates a possible risk of vascular pathology in the background of PD. DA receptor agonists not only normalize the state of lipid metabolism, but also significantly improve the neurological status of patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-course-of-parkinsons-disease-in-patients-with-impaired-carbohydrate-metabolism/