Metabolic-vascular burden and subsequent Parkinson's disease across Chinese, English, and European ageing cohorts

Metabolic and vascular disorders have been linked to Parkinson's disease (PD), but population-based evidence remains inconsistent. We examined whether harmonized metabolic-vascular burden was associated with subsequent reported PD across Chinese, English, and European ageing cohorts.

We analyzed participants aged 50 years or older in CHARLS, ELSA, and SHARE after excluding reported PD at exposure baseline. Metabolic-vascular burden was scored from 0 to 4 by summing diabetes, hypertension, dyslipidemia or high cholesterol, and body mass index > = 25 kg/m2. Subsequent reported PD was identified at follow-up waves. Cohort-specific logistic regression estimated odds ratios (ORs) per additional component, followed by random-effects meta-analysis.

The analytic sample included 111,142 participants and 1,332 follow-up PD events: 16,531 participants and 241 events in CHARLS, 13,581 and 134 in ELSA, and 81,030 and 957 in SHARE. In demographic-adjusted models, each additional component was associated with higher PD odds in CHARLS (OR 1.29, 95% CI 1.14-1.47) and SHARE (OR 1.13, 95% CI 1.07-1.20), but not ELSA (OR 1.03, 95% CI 0.85-1.25). The pooled demographic-adjusted OR was 1.16 (95% CI 1.04-1.29; I2 = 59.5%). Fully adjusted estimates were attenuated (pooled OR 1.07, 95% CI 0.90-1.28). Component models implicated diabetes and dyslipidemia in CHARLS and diabetes and BMI > = 25 kg/m2 in SHARE.

Metabolic-vascular burden showed a modest, heterogeneous association with subsequent reported PD. The findings support interpreting cardiometabolic-PD associations as population-context dependent rather than as a single transportable risk estimate.