帕金森与糖尿病关系.pptVIP

Meta-analysisandpooledRRsofPDindiabeticparticipantsfromprospectivecohortstudies(ForrestplotA[A],associationfoundforfullyadjustedestimates;ForrestplotB[B],associationfoundforfullyadjustedestimatesobtainedaftertheexclusionofparticipantswhohadvasculardiseaseatbaselineand/orwhodevelopedthemduringthefollow-up).d.f.,degreesoffreedom..PotentialsourcesofheterogeneitybetweenstudieswereassessedusingCochran’sQandI2statistics.Tocompensateforpotentialbetween-studyheterogeneity,wecalculatedapooledRRorORusingarandom-effectmodel(DerSimonian-Lairdmethod);otherwise,weusedfixedeffectmodels.AllanalyseswereperformedusingSTATA11(StataCorp,CollegeStation,TX),establishingthelevelofsignificanceatatwo-tailedPvalueof0.05.*Forrestplot(pooledOR)fortheassociationbetweenpre-existingdiabetesandPDincase-controlstudies:plotA(A),primaryanalysis(allstudies);plotB(B),sensitivityanalysis(studiesprovidingestimatesadjustedforBMI).I-V,inversevariancefixed-effectmodel;D+L,DerSimonian-Lairdrandom-effectmodel;d.f.,degreesoffreedom.*帕金森病与糖尿病的关系PDvsDM早在1974年，IvanJ.Lipman等人已注意到,帕金森病人中糖耐量异常的患者占了很大比例，并且与年龄、病程、和疾病分期无明显关联。近年来糖尿病与阿尔茨海默病（AD）和痴呆的研究为二者的相互关系提供了明确证据，提示神经系统变性疾病与糖尿病有不可忽视的联系。IvanJ.Lipman?,GlucoseintoleranceinparkinsonsdiseaseJournalofChronicDiseasesVolume27,Issues11–12,December1974,ArvanitakisZ,WilsonRS,BieniasJL,EvansDA,BennettDA.DiabetesmellitusandriskofAlzheimerdiseaseanddeclineincognitivefunction.ArchNeurol2004;61:661–666糖尿病可以引起多种并发症，长期血糖未得到良好控制可引起神经病变和微血管病变，可诱发血管性帕金森病；糖尿病急性并发症，如酮症酸中毒、高渗昏迷等神经系统损害也可引起继发性帕金森病，即帕金森综合症。FoltynieT,BarkerR,BrayneC.Vascularparkinsonism:areviewoftheprecisionandfrequencyofthediagnosis.Neuroepidemiology2002;21:1–7周蕾等，糖尿病酮症昏迷心肺复苏后致帕金森综合征报告《吉林医学》2010年6月31卷11期帕金森综合症流行病学调查负相关或无关正相关发表时间，2008年样本量，7,274人国家，UK病例对照研究：选择1994-2005年间首次诊断