Newly Diagnosed Anemia Increases Risk of Parkinson’s disease: A Population-Based Cohort Study

Abstract

Anemia and low hemoglobin have been identified to increase Parkinson’s disease (PD) risk. This population-based cohort study investigated PD risk in newly diagnosed anemic patients by using data from the Taiwan National Health Insurance Research Database. All newly diagnosed anemic patients (n = 86,334) without a history of stroke, neurodegenerative diseases, traumatic brain injury, major operations, or blood loss diseases were enrolled. A cohort of nonanemic controls, 1:1 matched with anemic patients on the basis of the demographics and pre-existing medical conditions, was also included. Competing risk analysis was used to evaluate PD risk in anemic patients compared with that in their matched controls. The adjusted hazard ratio (aHR) of PD risk in the anemic patients was 1.36 (95% confidence interval [CI]: 1.22–1.52, p < 0.001). Iron deficiency anemia (IDA) patients tended to exhibit a higher PD risk (aHR: 1.49; 95% CI: 1.24–1.79, p < 0.001). Furthermore, Iron supplement did not significantly affect the PD risk: the aHRs for PD risk were 1.32 (95% CI: 1.07–1.63, p < 0.01) and 1.86 (95% CI: 1.46–2.35, p < 0.001) in IDA patients with and without iron supplementation, respectively. The population-based cohort study indicated newly diagnosed anemia increases PD risk.

Blood Transcriptomic Meta-analysis Identifies Dysregulation of Hemoglobin and Iron Metabolism in Parkinson’ Disease

“…Furthermore, low levels of hemoglobin have been associated with disease severity in PD patients and late stage PD patients had lower levels of iron, ferritin, and total iron binding capacity compared to age-matched HCs (Deng et al, 2016). A recent study in a Taiwanese cohort of 86,334 patients demonstrated that newly diagnosed anemic patients have a higher risk of developing PD four or more years after the initial diagnosis of anemia (Hong et al, 2016). Thus, the mechanisms by which altered levels of hemoglobin and the presence of anemia might lead to the development of PD warrants further investigation.…”

“…In support of this finding, the risk of PD was higher among men who reported multiple blood donations, an indicator of reduced iron stores (Logroscino et al, 2006). Interestingly, anemia, a condition characterized by low hemoglobin levels and sometimes associated with iron deficiency, has been correlated with an increased risk of PD in several populations (Savica et al, 2009; Hong et al, 2016). In addition, it has been proposed that hemoglobin may play a role in the oxidative stress and mitochondrial dysfunction in PD (Shephard et al, 2016).…”

High exposure compared with standard exposure to metoclopramide associated with a higher risk of parkinsonism: a nationwide population‐based cohort study

“…As one of the largest databanks of medical information in the world, NHIRD provides a unique opportunity to assess the risk factors for various diseases. The application of NHIRD in risk factor evaluation for Parkinson's disease (PD) has been validated in a number of previous studies [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”

Anemia and the risk of Parkinson’s disease in Korean older adults: A nationwide population-based study

“…Some evidence suggest that anemia is potentially associated with development of PD, and results of previous studies concerning the relationship between anemia and PD have been controversial. A population-based cohort study using claims data in Taiwan demonstrated that newly diagnosed anemia increased the risk of PD 7 , and a previous case-control study in the U.S. showed that more patients in the PD group had anemia than patients in the control group 8 . However, another study found that increase in hemoglobin concentration in peripheral blood from <14 to ≥16 g/dL was associated with increased risk of PD in elderly men, and hemoglobin could serve as the most significant source of peripheral iron 9 .…”