Objective: We aimed to identify the impact of Metabolic syndrome (MS) in motor and non-motor symptoms of Parkinson’s disease (PD).

Background: PD is a common neurodegenerative disease. With the aging of the population, there is a tendency for an increase in the number of affected individuals. More recent studies have demonstrated that diseases that increase the risk of cardiovascular events may act as risk factors (RF) for PD. MS is a set of RF for the manifestation of cardiac and cerebrovascular diseases; therefore, it must be understood whether the presence of MS in patients with PD can alter the course of the disease, leading to greater impairment of motor and non-motor symptoms (NMS) compared to patients with PD alone, without MS.

Method: Five databases were searched between February and March 2025. Patients with PD (≥18 years old), with or without MS, were included from studies published between January 2010 and February 2025 where the progression of Parkinson’s Disease could be analyzed through scales/tests used in the follow-up of these patients (PROSPERO ID: CRD420251010170). GRADE was utilized to assess certainty (or confidence) in the bodies of evidence produced by the review.

Results: Seven studies were included (2 randomized controlled trials and 5 observational studies), totaling 65,047 patients, of whom 2,062 had PD and 441 also had MS. Ages ranged from 42 to 82 years across five countries. In pooled analysis, four studies assessed UPDRS/MDS-UPDRS progression in PD patients with MS: two reported slight motor worsening, while the others found no change. Furthermore, NMS were evaluated using various tests, such as MoCA, MDRS, SDMT, NMSS, and PDSS-2. Two studies detected mild cognitive decline, while one found no cognitive changes but reported significantly worse NMS in PD-MS patients. One study examined the risk of PD in MS patients and found no association but did identify a link with hypertension or diabetes mellitus alone. Overall, the studies showed a low risk of bias, with minor concerns in a few areas.

Conclusion: MS may contribute to worse progression of PD, with some studies reporting slight motor decline and more severe non-motor symptoms in PD-MS patients. However, findings were inconsistent, and the overall impact of MS on disease progression remains unclear. Given the limited and heterogeneous data, further studies are needed to better understand the influence of MS on PD outcomes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-metabolic-syndrome-on-parkinsons-disease-progression-a-systematic-review/