Lately, focus on the relation between Parkinson's disease (PD) and Diabetes has risen greatly, as neuroprotective properties have been attributed to insulin use. Several studies have assessed the effect of glitazones, an insulin-sensitizing agent, in diabetic population on PD future risk. However, reports on the effect of their use have been heterogeneous. We aimed to synthesize the available scientific evidence which assesses the effect of glitazone use in type 2 diabetes patients on PD incidence. A systematic review was performed on multiple electronic databases. Considered for inclusion were studies that assessed the incidence of PD in type 2 diabetes glitazone users. Two reviewers worked independently and in duplicate to assess all studies, extract information and assess the methodological quality in each included study. Four high quality retrospective cohorts fulfilled inclusion criteria. Comparison groups varied across studies. In each study, incidence of PD was lower in glitazone-exposed patients compared to their respective comparison group. Pooled analysis showed lesser risk of PD in ever versus never glitazone users (RR 0.75 [95% C.I. 0.67-0.85; p < .0001; I2 = 0]). Our pooled analysis showed lesser risk of PD in glitazone versus non glitazone users, however, we advise to take results with caution since results are non-adjusted to possible confounding variables, furthermore, different glitazone-exposure time, follow up and comparison groups are aspects that also need to be pointed out. More clinical research focused on glitazone use and its relation with PD is needed, as this could result in new potential treatment modalities.

中文翻译：

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格列酮治疗对预防成年糖尿病人群的帕金森病有作用吗？系统评价。

最近，对帕金森病 (PD) 和糖尿病之间关系的关注已大大增加，因为神经保护特性归因于胰岛素的使用。几项研究评估了格列酮（一种胰岛素增敏剂）在糖尿病人群中对 PD 未来风险的影响。然而，关于它们的使用效果的报告是异质的。我们旨在综合评估格列酮在 2 型糖尿病患者中使用对 PD 发病率的影响的现有科学证据。对多个电子数据库进行了系统评价。考虑纳入评估 2 型糖尿病格列酮使用者 PD 发病率的研究。两名评审员独立工作并重复评估所有研究，提取信息并评估每项纳入研究的方法学质量。四个高质量的回顾性队列符合纳入标准。比较组因研究而异。在每项研究中，格列酮暴露患者的 PD 发生率低于各自的对照组。汇总分析显示，与从未使用格列酮的患者相比，曾经使用过 PD 的风险更低（RR 0.75 [95% CI 0.67-0.85；p < .0001；I2 = 0]）。我们的汇总分析显示，与非格列酮使用者相比，格列酮使用者患 PD 的风险较低，但是，我们建议谨慎使用结果，因为结果未根据可能的混杂变量进行调整，此外，不同的格列酮暴露时间、随访和对照组是方面这也需要指出。需要更多关注格列酮使用及其与 PD 关系的临床研究，因为这可能会产生新的潜在治疗方式。