Objective: To explore the association between anemia and the risk of Parkinson’s disease.

Background: Parkinson’s disease (PD) is a common progressive neurodegenerative neurological disorder. More than 10 million people are living with PD worldwide. A sizable literature demonstrates anemia in early life precedes PD.

Method: Medline, EMBASE, and Cochrane database were searched for the published real-world evidence (RWE) studies reporting the association between anemia and risk of PD till January 2024. Two researchers independently screened search results and extracted data (design, follow-up, assessment of outcomes, and exposure). The quality of the included study was assessed using the Newcastle-Ottawa scale (NOS).  The primary outcome was the pooled risk of PD due to anemia. Subgroup analysis was also performed based on sex, and adjustment for potential confounding factors. A random-effect model was applied for meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria was used to assess the certainty of findings. All the statistical analysis was performed using RevMan software version 5.3.

Results: This meta-analysis is based on five studies with a total of 2917528. Among the included studies PD was identified using ICD-10 code and anemia was defined using WHO defintion. Included studies were of high quality. A non-significantly higher risk of PD was observed in anemic patients as compared to non-anemic patients with a pooled relative risk (RR) of 1.13 (95% CI: 0.97 – 1.32), p = 0.10 (Fig.1). Subgroup analysis revealed a non-significantly higher risk of PD among anemic men compared to women with a RR of 1.13 (95% CI: 0.95 – 1.35), p = 0.16. Evidence was of low certainty as per the GRADE rating system.

Conclusion: This meta-analysis found a non-significantly higher risk of PD among anemic patients as compared to non-anemic. Future well designed controlled studies are warranted for further transparency in the evidence.

Fig.1 Meta-analysis on PD risk

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MDS Abstracts - https://www.mdsabstracts.org/abstract/no-association-between-anemia-and-risk-of-parkinsons-disease-evidence-from-a-meta-analysis-using-real-world-evidence/