The Association between the Triglyceride-Glucose Index and the Incidence Risk of Parkinson's Disease: A Nationwide Cohort Study

Abstract

Objective We aimed to investigate the associations of the triglyceride-glucose index, which measures insulin resistance, and the incidence of Parkinson's disease. Methods Our study used the Health Screening Cohort database of the National Health Insurance Service of South Korea (2002-2019). We included 310,021 participants who had no previous history of Parkinson's disease and for whom more than 3 triglyceride-glucose index measurements were available. A diagnosis of Parkinson's disease was determined via the International Classification of Diseases Tenth edition (G20) with a specific reimbursement code for rare intractable diseases and a history of prescriptions for anti-Parkinsonism drugs. Results During a median of 9.64 years (interquartile range 8.72-10.53), 4,587 individuals (1.5%) had Parkinson's disease. Based on a multivariable time-dependent Cox proportional hazards model, a per-unit increase in triglyceride-glucose index score was associated with a significantly increased risk of Parkinson's disease (hazard ratio [HR]: 1.062; 95% confidence interval [CI] 1.007-1.119). In a sensitivity analysis, the triglyceride-glucose index was associated with the incidence of Parkinson's disease in a non-diabetes mellitus cohort (HR: 1.093; 95% CI 1.025-1.165), but not in the diabetes mellitus cohort (HR: 0.990; 95% CI 0.902-1.087). In a restricted cubic spline analysis, the association between the triglyceride-glucose index and the incidence risk of Parkinson's disease showed a nonlinear increasing (J-shaped) trend. Conclusion Our study demonstrated that higher triglyceride-glucose index scores were associated with the incidence of Parkinson's disease in the general population, particularly in a nondiabetic mellitus cohort.