Department of Health Research and Policy, Division of Epidemiology, Stanford University School of Medicine, Stanford, California, USA.
Mov Disord. 2010 Nov 15;25(15):2587-94. doi: 10.1002/mds.23361.
To assess the familial aggregation of Parkinson's disease (PD), we compared the cumulative incidence of PD among first-degree relatives of PD cases and controls. We identified newly diagnosed patients with PD (n = 573) during 1994 to 1995 within Kaiser Permanente Medical Care Program of Northern California and recruited 496 cases (87%) for the case-control study. Of 720 eligible controls matched by birth year and sex to cases, 541 (75%) agreed to participate. Information on family history of PD and other neurodegenerative diseases was obtained by in-person structured interview. We used the reconstructed cohort approach that provides a better estimate of the risk. The cumulative incidence of PD was significantly higher among relatives of PD patients compared with relatives of controls (2.0 vs. 0.7%; relative risk (RR) = 3.4, 95% confidence interval (CI) 1.9-5.9; P = 0.0001). The degree of familial aggregation was higher among first-degree relatives of Hispanic PD cases compared with Hispanic controls (3.7% vs. 0.4%; RR = 8.5, 95% CI 1.0-68.9) than it was among non-Hispanic Caucasian cases and controls (2.0% vs. 0.8%; RR = 2.7, 95% CI 1.5-5.1; P = 0.02). The familial aggregation of PD was stronger among the siblings of PD cases (RR = 5.4, 95% CI 1.8-16.0) than among parents (RR = 2.7, 95% CI 1.3-5.2). The incidence and familial aggregation of PD is highest among Hispanics, warranting further studies of genetic and environmental risk factors in the Hispanic population.
为了评估帕金森病(PD)的家族聚集性,我们比较了 PD 病例一级亲属与对照组中 PD 的累积发病率。我们在 1994 年至 1995 年期间在加利福尼亚州北部的 Kaiser Permanente 医疗保健计划中确定了新诊断的 PD 患者(n=573),并招募了 496 例(87%)参加病例对照研究。在与病例按出生年份和性别匹配的 720 名合格对照者中,有 541 名(75%)同意参与。通过面对面的结构化访谈获得了 PD 和其他神经退行性疾病家族史的信息。我们使用了重建队列方法,该方法可以更好地估计风险。与对照组亲属相比,PD 患者的亲属 PD 的累积发病率明显更高(2.0% vs. 0.7%;相对风险(RR)=3.4,95%置信区间(CI)1.9-5.9;P=0.0001)。与西班牙裔对照组相比,西班牙裔 PD 病例一级亲属的聚集程度更高(3.7% vs. 0.4%;RR=8.5,95%CI 1.0-68.9),而非西班牙裔白种人病例和对照组(2.0% vs. 0.8%;RR=2.7,95%CI 1.5-5.1;P=0.02)。PD 病例兄弟姐妹的 PD 家族聚集程度更强(RR=5.4,95%CI 1.8-16.0),而父母的聚集程度较低(RR=2.7,95%CI 1.3-5.2)。PD 的发病率和家族聚集程度在西班牙裔人群中最高,这需要进一步研究西班牙裔人群中的遗传和环境风险因素。