Institute of Neurology, University College London, London, United Kingdom.
Ann Neurol. 2012 Dec;72(6):893-901. doi: 10.1002/ana.23687. Epub 2012 Oct 15.
To evaluate the association between diagnosis of Parkinson disease (PD) and risk factors or early symptoms amenable to population-based screening.
A systematic review and meta-analysis of risk factors for PD.
The strongest associations with later diagnosis of PD were found for having a first-degree or any relative with PD (odds ratio [OR], 3.23; 95% confidence interval [CI], 2.65-3.93 and OR, 4.45; 95% CI, 3.39-5.83) or any relative with tremor (OR, 2.74; 95% CI, 2.10-3.57), constipation (relative risk [RR], 2.34; 95% CI, 1.55-3.53), or lack of smoking history (current vs never: RR, 0.44; 95% CI, 0.39-0.50), each at least doubling the risk of PD. Further positive significant associations were found for history of anxiety or depression, pesticide exposure, head injury, rural living, beta-blockers, farming occupation, and well-water drinking, and negative significant associations were found for coffee drinking, hypertension, nonsteroidal anti-inflammatory drugs, calcium channel blockers, and alcohol, but not for diabetes mellitus, cancer, oral contraceptive pill use, surgical menopause, hormone replacement therapy, statins, acetaminophen/paracetamol, aspirin, tea drinking, history of general anesthesia, or gastric ulcers. In the systematic review, additional associations included negative associations with raised serum urate, and single studies or studies with conflicting results.
The strongest risk factors associated with later PD diagnosis are having a family history of PD or tremor, a history of constipation, and lack of smoking history. Further factors also but less strongly contribute to risk of PD diagnosis or, as some premotor symptoms, require further standardized studies to demonstrate the magnitude of risk associated with them.
评估帕金森病（PD）诊断与可进行人群筛查的风险因素或早期症状之间的关联。
对 PD 的风险因素进行系统回顾和荟萃分析。
与 PD 后期诊断相关性最强的因素是一级亲属或任何亲属患有 PD（比值比 [OR]，3.23；95%置信区间 [CI]，2.65-3.93 和 OR，4.45；95% CI，3.39-5.83）或任何亲属患有震颤（OR，2.74；95% CI，2.10-3.57）、便秘（相对风险 [RR]，2.34；95% CI，1.55-3.53）或无吸烟史（当前与从不：RR，0.44；95% CI，0.39-0.50），每种情况都使 PD 的风险增加一倍以上。还发现了与焦虑或抑郁史、农药暴露、头部外伤、农村生活、β受体阻滞剂、农业职业和饮用井水、咖啡饮用、高血压、非甾体抗炎药、钙通道阻滞剂和酒精呈负显著关联，但与糖尿病、癌症、口服避孕药使用、手术绝经、激素替代疗法、他汀类药物、对乙酰氨基酚/扑热息痛、阿司匹林、饮茶、全身麻醉史或胃溃疡无关。在系统综述中，还发现了与血清尿酸升高呈负相关的其他关联，以及一些单项研究或存在矛盾结果的研究。
与 PD 后期诊断相关的最强风险因素是有 PD 或震颤家族史、有便秘史和无吸烟史。进一步的因素也会增加 PD 诊断的风险，但程度较弱，或者作为一些前驱症状，需要进一步进行标准化研究以证明与它们相关的风险程度。
