Objective: To determine the role of obesity in the development of Parkinson’s disease in a retrospective matched cohort study.
Background: Parkinson’s disease (PD) is a neurodegenerative disorder in which a unifying cause remains unknown. Cardiovascular risk factors have been associated with the development of PD (1-5). Obesity has been reported to be both a risk factor for PD, as well as potentially protective (6-11). The relationship between cardiovascular risk factors and the development of PD have not yet been assessed in a longitudinal manner, which is the goal of the present study. The Framingham Heart Study (FHS) is a multigenerational longitudinal cohort study that was started in 1948, which is well-known for its cardiovascular health studies (12). Neurological data, including PD diagnoses and examination data, has been collected by FHS researchers over the decades, and it is our goal to utilize the extensive cardiovascular risk factor data collected by FHS to determine if obesity, in addition to other cardiovascular risk factors, contribute to the risk of the development of PD.
Method: Participants in the FHS Original and Offspring cohorts were included in this study. Controls were randomly selected based on sex and age at baseline examination, 1:10. Cox proportional hazard regression models were used, adjusting for age and sex. PD diagnoses were made by a panel of movement disorders neurologists using the UK Brain Bank Criteria (UKBB) and other supporting clinical details after being flagged for review by FHS neurologists (13-14). We used p<0.05 for significance.
Results: Accounting for missing covariate data, the total number of participants, 117 total had PD, with 1170 controls. We found that higher BMI was associated with lower PD risk, with participants with BMI 25 kg/m2 to 30 kg/m2 having HR of 0.67 (CI 0.45-1.00; p = 0.05) and BMI >= 30 kg/m2 having HR 0.47 (CI 0.27-0.84; p = 0.01). When the overweight and obese BMI groups were combined, we noted a more robust association, with combined HR of 0.67 (0.41-0.86; p = 0.01).
Conclusion: Obesity is protective in the development of PD.
References: 1. De Lau LCL, Koudstaal PJ, Hofman A, Breteler MMB. Serum cholesterol levels and the risk of Parkinson’s disease. Am J Epidemiol 2006; 164: 998-1002.
2. Huang X, Alonso A, Guo X, et al. Statins, plasma cholesterol, and risk of Parkinson’s disease: a prospective study. Mov Disord 2015; 30(4) 552-559.
3. De Pablo-Fernandez E, Goldcare R, Pakpoor J, Noyce AJ, Warner TT. Association between diabetes and subsequent Parkinson disease: a record-linkage cohort study. Neurology 2018; 91: e139-142.
4. Vikdahl, M., Bäckman, L., Johansson, I. et al. Cardiovascular risk factors and the risk of Parkinson’s disease. Eur J Clin Nutr 69, 729–733 (2015). https://doi.org/10.1038/ejcn.2014.259
5. Hu G, Jousilahti P, Nissinen A, Antikainen R, Kivipelto M, Tuomilehto J. Body mass index and the risk of Parkinson disease. Neurology. 2006;67(11):1955-1959. doi:10.1212/01.wnl.0000247052.18422.e5
6. Chen J, Guan Z, Wang L, Song G, Ma B, Wang Y. Meta-analysis: overweight, obesity, and Parkinson’s disease [published correction appears in Int J Endocrinol. 2014;2014:306402]. Int J Endocrinol. 2014;2014:203930. doi:10.1155/2014/20393
7. Logroscino G, Sesso HD, Paffenbarger RS Jr, Lee IM. Body mass index and risk of Parkinson’s disease: a prospective cohort study. Am J Epidemiol. 2007;166(10):1186-1190. doi:10.1093/aje/kwm211
8. Wang YL, Wang YT, Li JF, Zhang YZ, Yin HL, Han B. Body Mass Index and Risk of Parkinson’s Disease: A Dose-Response Meta-Analysis of Prospective Studies. PLoS One. 2015;10(6):e0131778. Published 2015 Jun 29. doi:10.1371/journal.pone.0131778
9. Chen H, Zhang SM, Schwarzschild MA, Hernan MA, Willett WC, Ascherio A. Obesity and the risk of Parkinson’s disease. Am J Epidemiol. 2004;159(6):547–55. Epub 2004/03/09.
10. Ikeda K, Kashihara H, Tamura M, Kano O, Iwamoto K, Iwasaki Y. Body mass index and the risk of Parkinson disease. Neurology. 2007;68(24):2156-2157. doi:10.1212/01.wnl.0000269477.49238.ec
11. Jeong SM, Han K, Kim D, Rhee SY, Jang W, Shin DW. Body mass index, diabetes, and the risk of Parkinson’s disease. Mov Disord. 2020;35(2):236-244. doi:10.1002/mds.27922
12. Andersson C, Johnson AD, Benjamin EJ, Levy D, Vasan RS. 70-year legacy of the Framingham Heart Study. Nat Rev Cardiol. 2019;16(11):687-698. doi:10.1038/s41569-019-0202-5
13. Jain S, Himali J, Beiser A, Ton TG, Kelly-Hayes M, Biggs ML, Delaney JA, Rosano C, Seshadri S, Frank SA. Validation of secondary data sources to identify Parkinson disease against clinical diagnostic criteria. Am J Epidemiol. 2015 Feb 1;181(3):185-90. doi: 10.1093/aje/kwu326. Epub 2014 Dec 29. PMID: 25550359; PMCID: PMC4312428.
14. Hughes AJ, Daniel SE, Kilford L, et al. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a
clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-184
To cite this abstract in AMA style:S. O'Shea, Y. Liu, C. Liu, S. Frank, R. Au. Obesity is a protective factor for the development of Parkinson’s disease in participants of the Framingham Heart Study Cohort [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/obesity-is-a-protective-factor-for-the-development-of-parkinsons-disease-in-participants-of-the-framingham-heart-study-cohort/. Accessed September 22, 2023.
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