Borenstein A R, Mortimer J A, Schofield E, Wu Y, Salmon D P, Gamst A, Olichney J, Thal L J, Silbert L, Kaye J, Craig U L, Schellenberg G D, Galasko D R
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33612-3805, USA.
Neurology. 2007 May 22;68(21):1764-71. doi: 10.1212/01.wnl.0000262027.31623.b2.
To study cycad-derived products as possible risk factors for dementia, mild cognitive impairment (MCI), and parkinsonism-dementia complex (PDC) on Guam.
Complete risk factor data from in-person interviews of 166 cases of Guam dementia, 50 cases of amnestic MCI, and 21 cases of PDC were compared with 1,581 controls in the base population regarding exposure to cycad-derived products from a traditional food (fadang), consumption of fruit bats, and use of cycad-derived topical medicine.
Adjusted odds ratios (ORs) and 95% CIs for picking, processing, and eating fadang in young adulthood ranged from 1.42 (1.05 to 1.91) to 2.87 (1.48 to 5.56) and were consistently elevated and significant across all three diagnostic outcomes. Associations independent of exposure in young adulthood were for picking (OR 0.78, 95% CI 0.64 to 0.96) and processing (OR 0.77, 95% CI 0.63 to 0.94) fadang in childhood with Guam dementia. Men showed stronger and more consistent relations across exposure groups in young adulthood compared with women. No associations were found for consumption of fruit bats or exposure to cycad used as a topical medicine for any of the outcomes. Estimated adjusted population attributable risks suggest that exposure to eating fadang in young adulthood incurred the highest attributable risk percent.
Environmental lifestyle and diet may contribute to the etiology of neurodegenerative diseases in the native population of Guam.
研究苏铁衍生产品是否为关岛痴呆症、轻度认知障碍（MCI）和帕金森痴呆综合征（PDC）的潜在风险因素。
对166例关岛痴呆症患者、50例遗忘型MCI患者和21例PDC患者进行面对面访谈，获取完整的风险因素数据，并与1581名基础人群对照进行比较，内容涉及传统食物（法当）中的苏铁衍生产品暴露情况、果蝠食用情况以及苏铁衍生外用药的使用情况。
青年期采摘、加工和食用法当的校正比值比（OR）及95%置信区间为1.42（1.05至1.91）至2.87（1.48至5.56），在所有三种诊断结果中均持续升高且具有显著性。与青年期暴露无关的关联是儿童期采摘（OR 0.78，95%置信区间0.64至0.96）和加工（OR 0.77，95%置信区间0.63至0.94）法当与关岛痴呆症有关。与女性相比，男性在青年期各暴露组中的关系更强且更一致。对于任何一种结果，均未发现食用果蝠或接触用作外用药的苏铁之间存在关联。估计的校正人群归因风险表明，青年期食用法当的暴露导致的归因风险百分比最高。
环境生活方式和饮食可能对关岛原住民神经退行性疾病的病因有影响。
