{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:20Z","timestamp":1787014100765,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC25069003"],"award-info":[{"award-number":["2023YFC25069003"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parkinson's disease (PD) is an increasingly prevalent neurodegenerative condition, particularly among individuals with type 2 diabetes mellitus (T2DM). While prior studies have suggested that GLP\u20101 receptor agonists (GLP\u20101RAs) and metformin may confer neuroprotective effects, most were limited by small sample sizes, short follow\u2010up, uncontrolled designs, or lacked direct comparisons between therapies\u2014making their findings inconclusive for clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the TriNetX Global Collaborative Network, we identified 92\u2009485 patients with T2DM initiating GLP\u20101RA therapy and matched them 1:1 to new metformin users using propensity score matching. Patients with prior antidiabetic therapy, PD, or dementia were excluded. Incident PD was the primary outcome; all\u2010cause mortality served as a secondary endpoint. Adjusted hazard ratios (aHRs) were estimated using Cox models. Competing risk and time\u2010stratified (\u22645, 5\u201310, &gt;10\u2009years) analyses were conducted. Positive and negative outcome\/exposure controls were employed to validate internal consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall PD risk was comparable between GLP\u20101RA and metformin groups (aHR, 0.91; 95% CI, 0.79\u20131.05). However, between years 5 and 10, GLP\u20101RA use was associated with a significantly lower PD risk (aHR, 0.56; 95% CI, 0.34\u20130.93). Mortality risk did not differ significantly. Validation analyses confirmed the specificity of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By addressing key limitations of earlier studies through a large\u2010scale, active\u2010comparator, new\u2010user design, this study provides novel evidence of a delayed neuroprotective effect of GLP\u20101RAs. These findings support incorporating neurologic outcomes into long\u2010term diabetes management and may inform therapy selection in high\u2010risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70459","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T08:19:58Z","timestamp":1769415598000},"page":"2815-2826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>GLP<\/scp>\n                    \u2010\n                    <scp>1RAs<\/scp>\n                    versus metformin and Parkinson's risk in type 2 diabetes"],"prefix":"10.1111","volume":"28","author":[{"given":"Mingyang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine People's Hospital of Zhengzhou University, Henan Provincial People's Hospital  Zhengzhou Henan 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