Parkinson's Disease and Diabetes Mellitus: Synergistic Effects on Pathophysiology and GI Motility.

Q1 Medicine
Yun Yan, Dhanush Shimoga, Amol Sharma
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引用次数: 1

Abstract

Purpose of review: Parkinson's disease and diabetes affect an increasing proportion of the aging global population. Both conditions extensively affect gastrointestinal (GI) motility with similar and differing clinical symptoms. Nonetheless, GI symptoms in Parkinson's disease and diabetes pose significant morbidity and impairment of quality of life. Their pathophysiology is poorly understood, and therefore, effective treatment options are lacking.

Recent findings: Parkinson's disease patients have oropharyngeal dysphagia and constipation. They also have mild or absent upper GI symptoms associated with delayed gastric emptying, which is prevalent in 70% of patients. Delayed gastric emptying in Parkinson's disease leads to erratic medication absorption and fluctuating motor symptoms. Half of diabetics have upper GI symptoms, which correlate to gastric emptying and changes in brain activity of the insular cortex. The majority of diabetics also have constipation. Diabetics have an increased risk for developing Parkinson's disease and anti-diabetic medications are associated with risk reduction of developing Parkinson's disease. Hyperglycemia is associated with advanced glycated end products formation and acceleration of α-synuclein aggregation. GLP-1 receptor agonists have also demonstrated efficacy in improving motor symptoms and cognition in Parkinson's disease patients with diabetes. Parkinson's disease and diabetes are pan-enteric disorders with significant GI symptoms and impairment of gut motility. Both conditions have synergistic pathophysiologies that propagate neurodegenerative changes. Treatment options for GI symptoms in diabetic and Parkinson's disease patients are lacking. Anti-diabetic treatment improves motor symptoms in Parkinson's disease, however, its effect on GI symptoms is unclear.

帕金森病和糖尿病:病理生理和胃肠道运动的协同作用。
综述目的:帕金森病和糖尿病在全球老龄化人口中所占比例越来越大。这两种疾病都广泛影响胃肠道(GI)运动,具有相似和不同的临床症状。然而,帕金森病和糖尿病的胃肠道症状会造成严重的发病率和生活质量的损害。其病理生理机制尚不清楚,因此缺乏有效的治疗方案。最近发现:帕金森病患者有口咽吞咽困难和便秘。他们也有轻微或不存在与胃排空延迟相关的上消化道症状,这在70%的患者中很普遍。帕金森病胃排空延迟导致药物吸收不稳定和运动症状波动。一半的糖尿病患者有上消化道症状,这与胃排空和脑岛皮质活动的变化有关。大多数糖尿病患者也有便秘。糖尿病患者患帕金森氏症的风险增加,抗糖尿病药物与降低患帕金森氏症的风险有关。高血糖与晚期糖化终产物的形成和α-突触核蛋白聚集的加速有关。GLP-1受体激动剂也被证明对改善帕金森病合并糖尿病患者的运动症状和认知有疗效。帕金森病和糖尿病是泛肠道疾病,伴有明显的胃肠道症状和肠道运动障碍。这两种情况都有协同的病理生理,传播神经退行性变化。目前缺乏针对糖尿病和帕金森病患者胃肠道症状的治疗方案。抗糖尿病治疗可改善帕金森病患者的运动症状,但其对胃肠道症状的影响尚不清楚。
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来源期刊
Current Gastroenterology Reports
Current Gastroenterology Reports Medicine-Gastroenterology
CiteScore
7.80
自引率
0.00%
发文量
19
期刊介绍: As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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