Association of waist circumference with all cause mortality in Parkinson's disease

Abstract

Despite many previous studies on the association between metabolic syndrome and Parkinson disease (PD), only few studies have investigated the association between waist circumference (WC) and PD. The aim of this study is to investigate the association between WC and all-cause mortality in patients with PD. Among the whole nationwide population data from Korea National Health Insurance Service, newly diagnosed PD (ICD-10 code G20 and rare intractable disease registration code V124), between 2008 and 2017, were selected. All-cause mortality was the primary outcome. Anthropometric data, including WC and body mass index (BMI) were obtained from health screening data. The Cox proportional hazards model was used to assess mortality risk according to WC. Among the 22,118 patients with PD, 9,179 (41.50%) died during the 10-year follow-up period. WCs < 70 cm among males and < 65 cm among females were significantly associated with increased mortality in patients with PD (HR = 1.19, 95% CI, 1.05-1.34). After adjusting for BMI, WC of ≥ 90 cm in males or ≥ 85 cm in females, which are the criteria for central obesity, increased mortality risk significantly (M 90-100, F 85-95: HR = 1.13, 95% CI, 1.05-1.22; M ≥ 100, F ≥ 95: HR = 1.50, 95% CI, 1.33-1.68). The association between WC and PD mortality revealed a J-shaped pattern among males and a U-shaped pattern among females. Central obesity is a significant risk factor for mortality in patients with PD after adjusting for BMI. Our results suggest that management of WC is crucial for PD patients and that BMI should be considered in the WC management plan for mortality in PD.

Keywords: Body mass index; Mortality; Parkinson disease; Waist circumference.

Fig. 1

Restricted cubic spline plots of the association between waist circumference (WC) and all-cause mortality in individuals with Parkinson disease (PD). (A) Male and (B) Female.

Fig. 2

Adjusted hazard ratios with 95% confidence intervals for all-cause mortality in individuals with Parkinson disease (PD) according to obesity and central obesity.