Shih I-Fan, Starhof Charlotte, Lassen Christina Funch, Hansen Johnni, Liew Zeyan, Ritz Beate
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Scand J Work Environ Health. 2017 May 1;43(3):210-216. doi: 10.5271/sjweh.3633. Epub 2017 Mar 20.
Objectives This study aimed to examine whether occupational and physical activity (PA) at different ages contribute to Parkinson's disease (PD) risk in a large population-based case-control study in Denmark. Methods We identified 1828 PD patients from the Danish National Hospital Register and recruited 1909 gender and year of birth matched controls from the Danish Central Population Register. Occupational and leisure-time PA were determined from a job exposure matrix based on occupational history and self-reported leisure-time information. Results No association was found for occupational PA alone in men, but higher leisure-time PA (≥5 hours/week of strenuous activities) in young adulthood (15-25 years) was associated with a lower PD risk (adjusted odds ratio (OR ) 0.75, 95% confidence interval (95% CI) 0.62-0.90); men who engaged in high occupational and high leisure-time PA in young adulthood had the lowest PD risk (OR 0.58, 95% CI 0.41-0.81). Among women, inverse associations were found for occupation PA before age 50 (highest vs lowest, OR 0.75, 95% CI 0.55-1.06) and strenuous leisure-time PA after age 50 (OR 0.65, 95% CI 0.87-0.99); no clear pattern was seen for leisure and occupational PA combined. Conclusions We observed gender-specific inverse associations between occupational and leisure-time PA and PD risk; however, we cannot preclude reverse causation especially in older ages since PD has a long prodromal stage that might lead to a reduction of PA years before motor symptom onset and PD diagnosis.
在丹麦一项基于人群的大型病例对照研究中,本研究旨在探讨不同年龄段的职业活动和身体活动(PA)是否会增加帕金森病(PD)风险。方法:我们从丹麦国家医院登记处识别出1828例PD患者,并从丹麦中央人口登记处招募了1909名性别和出生年份匹配的对照。根据职业史和自我报告的休闲时间信息,通过工作暴露矩阵确定职业和休闲时间PA。结果:男性中仅职业PA未发现关联,但青年期(15 - 25岁)较高的休闲时间PA(≥5小时/周剧烈活动)与较低的PD风险相关(调整比值比(OR)0.75,95%置信区间(95%CI)0.62 - 0.90);青年期从事高职业和高休闲时间PA的男性PD风险最低(OR 0.58,95%CI 0.41 - 0.81)。在女性中,50岁之前的职业PA呈负相关(最高与最低相比,OR 0.75,95%CI 0.55 - 1.06),50岁之后的剧烈休闲时间PA呈负相关(OR 0.65,95%CI 0.87 - 0.99);休闲和职业PA综合来看没有明显模式。结论:我们观察到职业和休闲时间PA与PD风险之间存在性别特异性的负相关;然而,我们不能排除反向因果关系,特别是在老年人群中,因为PD有很长的前驱期,可能导致在运动症状出现和PD诊断前几年PA减少。