Objective: To investigate whether usage of dipeptidyl peptidase IV inhibitors (DPP4i) is associated decreased mortality in Parkinson’s disease (PD).

Background: Type 2 diabetes mellitus (T2DM) and PD share a common pathophysiology in terms of protein homeostasis and cellular clearing system dysregulation. Epidemiological studies revealed a close association between T2DM and PD. Patients with T2DM have a 35% increased risk of PD, and diabetes mellitus has a deteriorating impact on the longitudinal progression of motor and cognitive symptoms in PD. DPP4i are widely used anti-diabetics, which also have neuroprotective properties via pleotropic effects. Recent study revealed beneficial effects of DPP4i in diabetic PD patients in a hospital-based cohort, and epidemiological study revealed association between DPP4i and lower risk of PD in diabetic patients.

Method: We utilized sample cohort databases from National Health Insurance Service in Korea. We enrolled individuals who were diagnosed with PD for the first time between 2009 and 2019. A total of 3,219 PD patients were identified, and they were classified into three groups. (1) PD without T2DM (PD-DM^–), (2) PD with DM, but without any record for insurance claim of DPP4i (PD-DM⁺-DPP4i^–), and (3) PD with DM who had been prescribed any DPP4i (PD-DM⁺-DPP4i⁺). The Chi-square test and analysis of variance were used to compare demographics and comorbid conditions among the three groups. Survival analysis was performed through a log-rank test using Kaplan-Meier curves. We performed univariate and multivariate Cox proportional hazards analyses including age, sex, Charlson Comorbidity Index (CCI), hypertension, and osteoporosis as covariates.

Results: PD-DM^– group had more male sex than the other groups. Age at diagnosis was younger in PD-DM^– group compared to the other groups, and proportion of high CCI (CCI ≥2) was lower in higher in PD-DM^– group compare to the other groups. Proportion of hypertension was higher in the PD-DM⁺-DPP4i^– group compared to the other groups, and proportion of osteoporosis was lower in the PD-DM- group compared to the other groups. In Cox-regression analysis, PD-DM^– group and PD-DM⁺-DPP4i⁺ group had a lower risk of mortality compared to PD-DM⁺-DPP4i^– group, considering covariates.

Conclusion: The usage of DPP4 inhibitors in PD was associated with lower risk of mortality in PD participants with DM.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-dipeptidyl-peptidase-4-inhibitor-usage-and-mortality-in-parkinsons-disease-a-nation-wide-study/