title: Inverse Association of Parkinson Disease With Systemic Lupus Erythematosus: A Nationwide Population-based Study.
abstract: The effects of the inflammatory mediators involved in systemic lupus erythematous (SLE) on subsequent Parkinson disease have been reported, but no relevant studies have focused on the association between the 2 diseases. This nationwide population-based study evaluated the risk of Parkinson disease in patients with SLE.We identified 12,817 patients in the Taiwan National Health Insurance database diagnosed with SLE between 2000 and 2010 and compared the incidence rate of Parkinson disease among these patients with that among 51,268 randomly selected age and sex-matched non-SLE patients. A Cox multivariable proportional-hazards model was used to evaluate the risk factors of Parkinson disease in the SLE cohort.We observed an inverse association between a diagnosis of SLE and the risk of subsequent Parkinson disease, with the crude hazard ratio (HR) being 0.60 (95% confidence interval 0.45-0.79) and adjusted HR being 0.68 (95% confidence interval 0.51-0.90). The cumulative incidence of Parkinson disease was 0.83% lower in the SLE cohort than in the non-SLE cohort. The adjusted HR of Parkinson disease decreased as the follow-up duration increased and was decreased among older lupus patients with comorbidity.We determined that patients with SLE had a decreased risk of subsequent Parkinson disease. Further research is required to elucidate the underlying mechanism.
authors.affiliation: From the Rheumatology/Immunology and Allergy, Department of Medicine (F-CL); Department of Radiation Oncology (W-YH, K-TL); Department of Infectious Disease (T-YL); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center (C-HS); School of Public Health, National Defense Medical Center, Taipei (Y-CC); School of Medicine (C-LL); Management Office for Health Data (C-LL); Department of Nuclear Medicine and PET Center, China Medical University Hospital (C-HK); and Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK).
authors.forename: Feng-Cheng
authors.initials: FC
authors.lastname: Liu
authors.forename: Wen-Yen
authors.initials: WY
authors.lastname: Huang
authors.forename: Te-Yu
authors.initials: TY
authors.lastname: Lin
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Shen
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Chou
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Kuen-Tze
authors.initials: KT
authors.lastname: Lin
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000209:etiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan