Department of Epidemiology, UCLA School of Public Health, Los Angeles, California 90095-1772, USA.
Mov Disord. 2010 Jul 15;25(9):1210-6. doi: 10.1002/mds.23102.
The objective of this study was to investigate whether statin (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor) use is associated with risk of Parkinson's disease (PD) in Denmark. We identified 1,931 patients with a first time diagnosis of PD reported in hospital or outpatient clinic records between 2001 and 2006. We density matched to these patients 9,651 population controls by birth year and sex relying on the Danish population register. For every participant, we identified pharmacy records of statin and anti-Parkinson drug prescriptions since 1995 and before index date from a prescription medication use database for all Danish residents. Whenever applicable, the index dates for cases and their corresponding controls were advanced to the date of first recorded prescription for anti-Parkinson drugs. In our primary analyses, we excluded all statin prescriptions 2-years before PD diagnosis. Employing logistic regression adjusting for age, sex, diagnosis of chronic obstructive pulmonary disease, and Charlson comorbidity, we observed none to slightly inverse associations between PD diagnosis and statin prescription drug use. Inverse associations with statin use were only observed for short-term (<or=1 yrs) statin users (2-year lag OR 0.57; 95% CI 0.36 to 0.89); and suggested at higher intensity statin use (2-year lag OR 0.69; 95% CI 0.45-1.04). No associations were seen among long-term users and no difference by sex, age, or type of statins used (lipophilic/hydrophilic). We found little evidence for a neuroprotective role of statins in PD except for short-term or high intensity users. Yet, further investigations into the contributions of intensity, duration, and lag periods of statin use may still be warranted.
本研究旨在探讨丹麦人群中,他汀类药物(3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂)的使用是否与帕金森病(PD)发病风险相关。我们在 2001 年至 2006 年期间,于医院或门诊记录中识别出了 1931 例首次确诊为 PD 的患者。我们按照出生年份和性别,与这些患者进行密度匹配,匹配了 9651 名对照人群,这些对照人群来自丹麦人口登记系统。对于每一位参与者,我们通过丹麦所有居民的处方用药数据库,从 1995 年开始,在索引日期之前识别出他汀类药物和抗 PD 药物的处方记录。在适当的情况下,病例及其相应对照的索引日期提前到首次记录抗 PD 药物处方的日期。在我们的初步分析中,我们排除了 PD 诊断前 2 年内的所有他汀类药物处方。我们采用 logistic 回归模型,调整了年龄、性别、慢性阻塞性肺疾病诊断和 Charlson 合并症,结果观察到 PD 诊断与他汀类药物处方药物使用之间存在无到轻微的负相关关系。只有在短期(<=1 年)使用他汀类药物的患者中观察到与他汀类药物使用的负相关关系(2 年滞后 OR 0.57;95%CI 0.36 至 0.89);并且提示他汀类药物使用强度较高(2 年滞后 OR 0.69;95%CI 0.45 至 1.04)。在长期使用者中未观察到相关性,且在性别、年龄或使用的他汀类药物类型(亲脂性/亲水性)方面也无差异。我们发现他汀类药物在 PD 中几乎没有神经保护作用,除了短期或高强度使用者。然而,进一步研究他汀类药物使用的强度、持续时间和滞后期对 PD 的作用可能仍然是必要的。