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. 2019 Feb 12;16(1):5.
doi: 10.1186/s12987-019-0125-x.

Comorbidity of diabetes mellitus in idiopathic normal pressure hydrocephalus: a systematic literature review

Miles Hudson  1 , Caden Nowak  2 , Richard J Garling  2 , Carolyn Harris  2
Affiliations

Comorbidity of diabetes mellitus in idiopathic normal pressure hydrocephalus: a systematic literature review

Miles Hudson et al. Fluids Barriers CNS. .

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is a subtype of hydrocephalus that occurs more often in the elderly population. It is usually characterized by gait disturbance, dementia and urinary incontinence. Epidemiological studies indicate that 15.7-17.8% of iNPH patients present with type-2 diabetes mellitus (DM). A review of the primary literature shows that these occurrence rates are higher than age- and cohort-matched non-iNPH controls. This suggests that this already vulnerable patient group has an increased risk for presenting with DM compared to their non-iNPH counterparts. Postoperative outcome when treating iNPH patients is inversely related to the number of patient comorbidities and a lower comorbidity status is correlated with better outcomes. This review highlights the need for further research into the relationship between iNPH and DM and speculates on a possible mechanism for an association between the development of ventriculomegaly and the development of DM and iNPH.

Keywords: DM; GH; IGF-1; NPH; iNPH.

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Figures

Fig. 1
Fig. 1
DM rates in iNPH group compared to control. The percentage of patients in each case controlled study presenting with DM in either the iNPH group or the study’s control group (varying by study). Number of patients in each group: N iNPH, C control. Eide: N-440, C-43,387, Jaraj: N-26, C-130, Jacobs: N-33, Kraus: N-63, C-70, Casmiro: N-4, C-2 Israelsson: N: 38, C-44, Pyykko: N-283, C-253. Studies indicated with a “*” had statistically significant results P < .05, “**” = P < .01, “***” = P < .001 (error bars were unavailable for the above studies)
Fig. 2
Fig. 2
Hypothetical association between ventriculomegaly and diabetes mellitus. Proposed mechanism for ventriculomegaly, and the subsequent development of diabetes mellitus. HPA hypothalamic pituitary axis, GH growth hormone, IGF-1 insulin-like growth factor
See this image and copyright information in PMC

References

    1. Shprecher D, Schwalb J, Kurlan R. Normal pressure hydrocephalus: diagnosis and treatment. Curr Neurol Neurosci Rep. 2008;8(5):371–376. doi: 10.1007/s11910-008-0058-2. - DOI - PMC - PubMed
    1. Wang C, Du H, Yin L, He M, Zhang G, Tian Y, et al. Analysis of related factors affecting prognosis of shunt surgery in patients with secondary normal pressure hydrocephalus. Chin J Traumatol. 2013;16(4):221–224. - PubMed
    1. Nassar BR, Lippa CF. Idiopathic normal pressure hydrocephalus. Gerontol Geriatr Med. 2016;2:233372141664370. doi: 10.1177/2333721416643702. - DOI - PMC - PubMed
    1. Vacca V. Diagnosis and treatment of idiopathic normal pressure hydrocephalus. J Neurosci Nurs. 2007;39(2):107–111. doi: 10.1097/01376517-200704000-00007. - DOI - PubMed
    1. Meier U, Lemcke J. The influence of co-morbidity on the postoperative outcomes of patients with idiopathic normal pressure hydrocephalus (iNPH) Acta Neurochir Suppl. 2008;102:141–144. doi: 10.1007/978-3-211-85578-2_29. - DOI - PubMed

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