Abbott Robert D, Ross G Webster, Petrovitch Helen, Tanner Caroline M, Davis Daron G, Masaki Kamal H, Launer Lenore J, Curb J David, White Lon R
Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, Virginia 22908-0717, and Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA.
Mov Disord. 2007 Aug 15;22(11):1581-6. doi: 10.1002/mds.21560.
It is not known if constipation is associated with the preclinical phase of Parkinson's disease (PD), often characterized by the presence of incidental Lewy bodies (ILB). Such an association could provide evidence that constipation is an early symptom of PD. The purpose of this report is to examine the association between late-life bowel movement frequency and ILB. Bowel movement frequency was assessed from 1991 to 1993 in 245 men aged 71 to 93 years in the Honolulu-Asia Aging Study who later received postmortem examinations. All were without clinical PD and dementia. Brains were examined for ILB in the substantia nigra and locus ceruleus. Among the decedents, 30 men had ILB (12.2%). After age-adjustment, the percent of brains with ILB declined with increasing bowel movement frequency (P=0.013). For men with <1, 1, and >1 bowel movement/day, corresponding percents were 24.1, 13.5, and 6.5%. Findings persisted after additional adjustment for time to death, mid-life pack-years of smoking and coffee intake, physical activity, and cognitive function. Infrequent bowel movements are associated with ILB. Findings provide evidence that constipation can predate the extrapyramidal signs of PD. Constipation could be one of the earliest markers of the beginning of PD processes.
尚不清楚便秘是否与帕金森病（PD）的临床前期相关，该阶段通常以存在路易小体（ILB）为特征。这种关联可以为便秘是帕金森病的早期症状提供证据。本报告的目的是研究晚年排便频率与路易小体之间的关联。在檀香山亚洲老年研究中，对1991年至1993年间年龄在71至93岁的245名男性的排便频率进行了评估，这些男性后来接受了尸检。所有人均无临床帕金森病和痴呆症。对大脑进行检查，以确定黑质和蓝斑中的路易小体。在这些死者中，30名男性有路易小体（12.2%）。年龄调整后，有路易小体的大脑百分比随着排便频率的增加而下降（P=0.013）。对于每天排便次数<1次、1次和>1次的男性，相应的百分比分别为24.1%、13.5%和6.5%。在对死亡时间、中年吸烟包年数和咖啡摄入量、身体活动以及认知功能进行额外调整后，这些发现仍然存在。排便次数少与路易小体有关。研究结果表明便秘可能早于帕金森病的锥体外系症状出现。便秘可能是帕金森病进程开始的最早标志之一。
