ScholarWorks@중앙대학교

초록

BACKGROUND: Dipeptidyl peptidase-4 inhibitors (DPP4i) are commonly used oral hypoglycemic agents that enhance the bioavailability of active glucagon-like peptide-1 by inhibiting its degradation. Recent studies suggest possible neuroprotective effects of DPP4i in Parkinson's disease (PD); however, their association with mortality in PD is unclear. METHODS: This retrospective cohort study analyzed the Korean National Health Insurance Service database. The cohort included 1093 adults diagnosed with both PD and type 2 diabetes (DM) between 2009 and 2019. We divided the participants into two groups: those not receiving DPP4i (PD-DPP4i+, n&#xa0;=&#xa0;557) and those treated with DPP4i (PD-DPP4i-, n&#xa0;=&#xa0;536). We used Kaplan-Meier survival analyses and Cox proportional hazard models to evaluate survival rates. Cox regression models included age, sex, number of comorbidities, and end-organ complication of DM including diabetic neuropathy and retinopathy as covariates. RESULTS: The average age of the study participants was 73.40 (&#xb1;7.67) years, and the majority were female (n&#xa0;=&#xa0;674, 61.67&#xa0;%). Kaplan-Meier analysis revealed the lower risk of mortality in the PD-DPP4i+ group (p&#xa0;<&#xa0;0.0001). The Cox proportional hazards regression model indicated that PD-DPP4i+ group had a lower risk of death compared to PD-DPP4i- group (hazard ratio, 0.762; 95&#xa0;% confidence interval, 0.611-0.949; p&#xa0;=&#xa0;0.0153). Factors including male sex, older age at PD diagnosis, and the presence of more than two comorbidities were associated with an increased risk of death. CONCLUSIONS: These findings suggest that the use of DPP4i in PD patients with co-existing DM is associated with lower risk of mortality. Copyright © 2025 Elsevier Ltd. All rights reserved.

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