If Not Insulin Resistance so What? – Comparison of Fasting Glycemia in Idiopathic Parkinson’s Disease and Atypical Parkinsonism

Abstract

Background

Parkinson’s disease (PD) is a synucleinopathy, which presents dysautonomia, as its common non-motor symptom. Some research suggests the existing interplay between the autonomic nervous system dysfunction and glucose metabolism dysregulation in PD.

Objective

To determine the prevalence of metabolic disorders with particular emphasis on glucose metabolism in patients with PD and atypical parkinsonism (AP).

Patients and Methods

A retrospective study was performed by analyzing 461 clinical data of consecutive patients diagnosed with PD, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) hospitalized from 2019 to 2021 in the authors’ institution. The study group included 350 patients (303 PD, 14 MSA, 33 PSP), aged 65.8 ± 9.7 years (42% were female). Laboratory results (fasting glycemia, lipid parameters, TSH, homocysteine and vitamin D3 levels) were collected. The patient’s clinical condition was assessed in III part of Unified Parkinson’s Disease Rating Scale (UPDRS p. III), Hoehn–Yahr scale, Mini Mental State Examination (MMSE) and Beck Depression Inventory (BDI).

Results

Impaired fasting glycemia (IGF) was more prevalent in PD than in the PSP (43.43% vs 18.18%; p = 0.043). Similarly, PD presented a higher level of fasting glycemia (102.4 ± 16.7 mg/dl vs 92.2 ± 16.1mg/dl; p = 0.042). According to lipid parameters, patients with PD showed lower LDL cholesterol (92.3 ± 44.3mg/dl vs 119 ± 61.0mg/dl; p = 0.016) and lower BMI compared to patients with PSP (26.1 ± 4.0kg/m² vs 29.3 ± 4.4 kg/m²; p = 0.024), but there were no statistically significant differences in triglycerides (TG) and HDL cholesterol levels. Males with PD presented greater frequency of IFG (35.05% vs 50.6%; p = 0.042), higher fasting glycemia (99.1 ± 14.3mg/dl vs 103.7 ± 14.7mg/dl; p = 0.006), lower total cholesterol, HDL cholesterol, and BMI compared to women with PD.

Conclusion

Our investigation supports an association between synucleinopathies and glucose metabolism dysregulation.

Keywords:

• Parkinson’s disease
• atypical parkinsonism
• diabetes mellitus
• impaired fasting glycemia

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki. Ethical review and approval were waived for this study, due to the retrospective character of the work and data anonymization. The Ethics Committee of the Medical University of Silesia waived the requirement to obtain the ethical approval for this study.

Informed Consent Statement

Patient consent was waived due to the retrospective character of the work and data anonymization.

Data Sharing Statement

The data presented in this study are available on request from the corresponding author.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research received no external funding.