Vidal Jean-Sébastien, Vidailhet Marie, Elbaz Alexis, Derkinderen Pascal, Tzourio Christophe, Alpérovitch Annick
INSERM U708, Neuroepidemiology, Paris, France.
Mov Disord. 2008 Apr 30;23(6):797-803. doi: 10.1002/mds.21857.
Multiple system atrophy (MSA) is a rare sporadic progressive neurodegenerative disorder. MSA risk factors are poorly known. The objectives of this case-control study were to study environmental risk factors associated with MSA. Cases were recruited through five French referral centers. Controls matched for age, gender, and living area were recruited from healthy relatives of inpatients free of any parkinsonian syndrome of the same centers. Subjects were interviewed about exposure to environmental factors (pesticides, solvents, etc.), occupation and food habits, and use of anti-inflammatory drugs. Odds ratios and 95% confident intervals (OR [95% CI]) were computed using conditional logistic regression. Seventy-one cases and 71 matched controls were included. Low education level was more frequent in cases than in controls. Controls drank more alcohol than did cases (OR = 0.5 [0.2-1.1]) and the risk of MSA decreased with increasing alcohol consumption (P = 0.04). Controls ate fish and sea food more often and drank more tea than cases. Aspirin intake was more frequent among controls than did cases (OR = 0.5 [0.2-1.0]) and the risk of MSA decreased with the frequency of intake (P = 0.0002). MSA was not associated to exposure to pesticides, solvents, and other toxics neither to occupations, except plant and machine operators and assemblers (OR = 10.0 [2.1-47.5]) where the risk of MSA increased with number of years in this occupation (P = 0.004). This case-control study provided new findings about risk factors of MSA. On another hand, it did not confirm the previously reported association between MSA and exposure to pesticides.
多系统萎缩（MSA）是一种罕见的散发性进行性神经退行性疾病。MSA的风险因素鲜为人知。本病例对照研究的目的是研究与MSA相关的环境风险因素。病例通过五个法国转诊中心招募。年龄、性别和居住地区相匹配的对照从同一中心无任何帕金森综合征的住院患者的健康亲属中招募。就环境因素（农药、溶剂等）暴露、职业和饮食习惯以及抗炎药物的使用情况对受试者进行访谈。使用条件逻辑回归计算比值比和95%置信区间（OR[95%CI]）。纳入了71例病例和71例匹配对照。病例组的低教育水平比对照组更常见。对照组饮酒比病例组多（OR = 0.5[0.2 - 1.1]），且MSA风险随饮酒量增加而降低（P = 0.04）。对照组比病例组更常食用鱼类和海鲜，且喝茶更多。对照组服用阿司匹林比病例组更频繁（OR = 0.5[0.2 - 1.0]），且MSA风险随服用频率降低（P = 0.0002）。MSA与农药、溶剂和其他毒物暴露无关，也与职业无关，但植物和机器操作员及装配工除外（OR = 10.0[2.1 - 47.5]），在该职业中MSA风险随工作年限增加而增加（P = 0.004）。本病例对照研究提供了关于MSA风险因素的新发现。另一方面，它并未证实先前报道的MSA与农药暴露之间的关联。
