Benedetti M D, Bower J H, Maraganore D M, McDonnell S K, Peterson B J, Ahlskog J E, Schaid D J, Rocca W A
Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Neurology. 2000 Nov 14;55(9):1350-8. doi: 10.1212/wnl.55.9.1350.
To study the association of PD with preceding smoking, alcohol, and coffee consumption using a case-control design.
The authors used the medical records linkage system of the Rochester Epidemiology Project to identify 196 subjects who developed PD in Olmsted County, MN, during the years 1976 to 1995. Each incident case was matched by age (+/-1 year) and sex to a general population control subject. The authors reviewed the complete medical records of cases and control subjects to abstract exposure information.
For coffee consumption, the authors found an OR of 0.35 (95% CI = 0.16 to 0.78, p = 0.01), a dose-effect trend (p = 0.003), and a later age at PD onset in cases who drank coffee compared with those who never did (median 72 versus 64 years; p = 0.0002). The inverse association with coffee remained significant after adjustment for education, smoking, and alcohol drinking and was restricted to PD cases with onset at age <72 years and to men. The OR for cigarette smoking was 0.69 (95% CI = 0.45 to 1.08, p = 0.1). The authors found no association between PD and alcohol consumption. Extreme or unusual behaviors such as tobacco chewing or snuff use and a diagnosis of alcoholism were significantly more common in control subjects than cases.
These findings suggest an inverse association between coffee drinking and PD; however, this association does not imply that coffee has a direct protective effect against PD. Alternative explanations for the association should be considered.
采用病例对照设计研究帕金森病(PD)与既往吸烟、饮酒及咖啡饮用之间的关联。
作者利用罗切斯特流行病学项目的医疗记录链接系统,确定了1976年至1995年间在明尼苏达州奥尔姆斯特德县患帕金森病的196名受试者。每例新发病例按年龄(±1岁)和性别与一名普通人群对照受试者进行匹配。作者查阅了病例和对照受试者的完整医疗记录,以提取暴露信息。
对于咖啡饮用,作者发现比值比(OR)为0.35(95%置信区间[CI]=0.16至0.78,p=0.01),存在剂量效应趋势(p=0.003),且与不喝咖啡的病例相比,喝咖啡的病例帕金森病发病年龄较晚(中位数分别为72岁和64岁;p=0.0002)。在对教育程度、吸烟和饮酒进行调整后,与咖啡的负相关仍然显著,且仅限于发病年龄<72岁的帕金森病病例和男性。吸烟的OR为0.69(95%CI=0.45至1.08,p=0.1)。作者未发现帕金森病与饮酒之间存在关联。在对照受试者中,嚼烟草或吸鼻烟等极端或异常行为以及酒精中毒诊断比病例更为常见。
这些发现表明咖啡饮用与帕金森病之间存在负相关;然而,这种关联并不意味着咖啡对帕金森病有直接的保护作用。应考虑该关联的其他解释。