Ascherio A, Zhang S M, Hernán M A, Kawachi I, Colditz G A, Speizer F E, Willett W C
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Ann Neurol. 2001 Jul;50(1):56-63. doi: 10.1002/ana.1052.
Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in two ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every two to four years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23-0.78; p for trend < 0.001) for men in the top one-fifth of caffeine intake compared to those in the bottom one-fifth. An inverse association was also observed with consumption of coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend < 0.001), and tea (p for trend = 0.02) but not decaffeinated coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1-3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease.
病例对照研究以及针对男性的一项前瞻性调查结果表明,饮用咖啡可能有助于预防帕金森病,但其中的活性成分尚不清楚。为了验证咖啡因对帕金森病具有预防作用这一假设,我们在两项正在进行的队列研究,即健康专业人员随访研究(HPFS)和护士健康研究(NHS)中,考察了咖啡和咖啡因摄入量与帕金森病患病风险之间的关系。研究人群包括47351名男性和88565名女性,他们在基线时均未患帕金森病、中风或癌症。参与者在基线时完成了一份全面的生活方式和饮食问卷,并每两到四年更新一次。在随访期间(男性为10年,女性为16年),我们共记录了288例帕金森病新发病例。在男性中,调整年龄和吸烟因素后,咖啡因摄入量处于最高五分之一的男性患帕金森病的相对风险为0.42(95%可信区间:0.23 - 0.78;趋势检验p值<0.001),而摄入量处于最低五分之一的男性相比。咖啡饮用(趋势检验p值=0.004)、非咖啡来源的咖啡因(趋势检验p值<0.001)和茶(趋势检验p值=0.02)的摄入量也呈负相关,但脱咖啡因咖啡则不然。在女性中,咖啡因或咖啡摄入量与帕金森病风险之间的关系呈U形,在中等摄入量(每天1 - 3杯咖啡,或咖啡因摄入量的第三个五分位数)时风险最低。这些结果支持了中等剂量咖啡因可能对帕金森病风险具有预防作用的观点。