Simon Kelly Claire, Chen Honglei, Schwarzschild Michael, Ascherio Alberto
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Neurology. 2007 Oct 23;69(17):1688-95. doi: 10.1212/01.wnl.0000271883.45010.8a. Epub 2007 Aug 29.
To determine whether history of hypertension, hypercholesterolemia, or diabetes is associated with risk of Parkinson disease (PD).
Prospective study among participants in two large cohorts: the Nurses' Health Study (121,046 women) and the Health Professionals Follow-up Study (50,833 men). Mean duration of follow-up was 22.9 years in women, aged 30 to 55 years at baseline, and 12.6 years in men, aged 40 to 75 years at baseline. Relative risks (RRs) of PD were estimated from a Cox proportional hazards model adjusting for potential confounders.
We identified a total of 530 incident cases of PD during the follow-up. Risk of PD was not associated with self-reported history of hypertension (RR = 0.96, 95% CI = 0.80 to 1.15), high cholesterol (RR = 0.98, 95% CI = 0.82 to 1.19), or diabetes (RR = 1.04, 95% CI = 0.74 to 1.46), after adjusting for age and smoking in pack-years. Risk of PD decreased modestly with increasing levels of self-reported total cholesterol (RR for a 50-mg/dL increase in total cholesterol = 0.86, 95% CI = 0.78 to 0.95, p for trend = 0.02), but use of cholesterol-lowering drugs was not associated with PD risk (RR comparing users with nonusers = 0.85, 95% CI = 0.59 to 1.23). Among individuals with PD, systolic blood pressure was similar to noncases up to the time of diagnosis but declined afterward.
Results of this large prospective study suggest that Parkinson disease risk is not significantly related to history of hypertension, hypercholesterolemia, or diabetes but may modestly decline with increasing blood cholesterol levels.
确定高血压、高胆固醇血症或糖尿病病史是否与帕金森病(PD)风险相关。
对两个大型队列的参与者进行前瞻性研究,即护士健康研究(121,046名女性)和卫生专业人员随访研究(50,833名男性)。基线时,女性年龄在30至55岁之间,平均随访时间为22.9年;男性年龄在40至75岁之间,平均随访时间为12.6年。通过Cox比例风险模型估计PD的相对风险(RR),并对潜在混杂因素进行校正。
随访期间共识别出530例PD新发病例。在校正年龄和吸烟包年数后,PD风险与自我报告的高血压病史(RR = 0.96,95% CI = 0.80至1.15)、高胆固醇血症(RR = 0.98,95% CI = 0.82至1.19)或糖尿病病史(RR = 1.04,95% CI = 0.74至1.46)均无关联。随着自我报告的总胆固醇水平升高,PD风险略有降低(总胆固醇每增加50mg/dL的RR = 0.86,95% CI = 0.78至0.95,趋势p值 = 0.02),但使用降胆固醇药物与PD风险无关(使用者与非使用者比较的RR = 0.85,95% CI = 0.59至1.23)。在PD患者中,诊断前收缩压与非患者相似,但之后会下降。
这项大型前瞻性研究结果表明,帕金森病风险与高血压、高胆固醇血症或糖尿病病史无显著关联,但可能随血液胆固醇水平升高而略有下降。