Abstract
Few studies have shown an increased risk of Parkinson’s disease (PD) with the use of proton pump inhibitors (PPIs), and the pathophysiological mechanism for this association has not been unveiled. This study examined the relationship between PPI use and PD in a Korean population. We investigated 3026 PD patients and 12,104 controls who were matched by age, sex, income, and region of residence at a ratio of 1:4 in the Korean National Health Insurance Service, National Sample Cohort between 2002 and 2015. We estimated the associations between current and past use of PPIs and PD using odds ratios (ORs) and 95% confidence intervals (CIs) in a conditional/unconditional logistic regression after adjusting for probable confounders. Compared with PPI nonusers, both current users and past users had significantly greater odds of having PD, with ORs of 1.63 (95% CI = 1.44–1.84) and 1.12 (95% CI = 1.01–1.25), respectively. A significant association with PD was observed in individuals who used PPIs for 30–90 days and ≥90 days (OR = 1.26 and 1.64, 95% CI = 1.12–1.43 and 1.43–1.89) but not among those who used PPIs for <30 days. Both current and past use of PPIs associated with a higher probability of PD in the Korean population. Our study provides evidence regarding the association between PPI exposure and PD, but further investigation and possible explanations are warranted.
Highlights
Parkinson’s disease (PD) is an age-related progressive neurodegenerative disorder characterized mainly by dopamine-producing neuronal loss in the substantia nigra in the midbrain, and it produces a broad spectrum of motor and nonmotor manifestations [1]. much progress has been made in comprehension the etiopathogenesis of PD, the primary cause of neuronal death in PD remains elusive
All durations of pump inhibitors (PPIs) use were related to a significantly elevated likelihood of having PD in analyses for first-generation PPIs, but the use of PPIs for ≥90 days was significantly related to a higher likelihood of having PD in analyses for second-generation PPIs
Subgroup analyses stratified by various covariates and adjusted odds ratios (ORs) of the associations of PPI use with PD relative to nonusers were generally consistent with the primary results (Table S1)
Summary
Parkinson’s disease (PD) is an age-related progressive neurodegenerative disorder characterized mainly by dopamine-producing neuronal loss in the substantia nigra in the midbrain, and it produces a broad spectrum of motor and nonmotor manifestations [1]. much progress has been made in comprehension the etiopathogenesis of PD, the primary cause of neuronal death in PD remains elusive. A variety of factors, including genetic predispositions and/or environmental exposure to toxins, might be etiologies triggering the onset of PD. It is accepted that several drugs commonly prescribed, including nonsteroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs), and statins, are associated with PD risk [2]. Proton pump inhibitors (PPIs) are broadly prescribed to manage numerous gastrointestinal disorders, including gastric or duodenal ulcer disease, gastroesophageal reflux disease (GERD), Helicobacter pylori infection, and pathological hypersecretory conditions, and to prevent gastrointestinal bleeding in patients receiving antiplatelet therapy or taking. A great deal of evidence from the past several years has suggested that PPI therapy is associated with a higher risk of numerous adverse effects, such as cardiovascular disease, both acute and chronic kidney disease, hypomagnesemia, Clostridium difficile infection, pneumonia, dementia, upper gastrointestinal cancer, and osteoporotic fractures [4]
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