Abstract
INTRODUCTION: Although metabolically unhealthy obesity is an established independent risk factor for Parkinson’s disease, large-scale epidemiological evidence is lacking on whether metabolic and bariatric surgery (MBS), an obesity treatment, reduces Parkinson’s disease risk in people with obesity. This study aimed to evaluate the impact of MBS on Parkinson’s disease prevalence in people with obesity. METHODS: This multicenter, cross-sectional study utilized data from the 2018–2019 National Inpatient Sample (NIS) database. Hospitalized adult patients with obesity were stratified into MBS and non-MBS groups based on surgical history. Propensity score matching (PSM) balanced demographics and associated medical problems. Pearson’s chi-square test, Wilcoxon rank-sum test, and logistic regression assessed the association between MBS and Parkinson’s disease risk. RESULTS: From 2018 to 2019, 1,635,715 patients with obesity met inclusion criteria: 49,969 with MBS history (MBS group) and 1,585,746 without (non-MBS group). After PSM, the MBS group had significantly lower overall Parkinson’s disease prevalence (0.4% vs. 0.6%, p < 0.001) and primary Parkinson’s disease prevalence (0.4% vs. 0.6%, p < 0.001) than the non-MBS group. Undergoing MBS was independently associated with significantly reduced overall and primary Parkinson’s disease risk. CONCLUSION: This study suggests that people with obesity who undergo MBS were associated with a significant 30% reduction in primary and overall Parkinson’s disease risk. MBS did not significantly affect secondary Parkinson’s disease risk. This suggests MBS may specifically modulate Parkinson’s disease pathology; future research should investigate different procedures and timing for precise prevention in high-risk populations.