Liu Zhiwei, Roosaar Ann, Axéll Tony, Ye Weimin
Am J Epidemiol. 2017 Apr 1;185(7):538-545. doi: 10.1093/aje/kww146.
Few studies have investigated the associations between use of Swedish moist snuff (snus), associated poor oral health, and risk of Parkinson's disease (PD). We followed 20,175 participants who were free of PD in 1973-1974 in Uppsala, Sweden, until the end of 2012. We used Cox proportional hazards regression models to estimate hazard ratios and corresponding 95% confidence intervals for the associations between tobacco use, oral health indicators, and PD risk. We found that tobacco use was associated with a lower risk of PD in males. Compared with males who never used any tobacco daily, pure ever tobacco smokers, pure ever snus users, and combined users had adjusted hazard ratios of 0.68 (95% confidence interval (CI): 0.49, 0.93; n = 83), 0.51 (95% CI: 0.27, 0.95; n = 11), and 0.21 (95% CI: 0.07, 0.67; n = 3), respectively. No association was observed for number of teeth, dental plaque, or detectable oral mucosal lesions and PD risk, although there was a suggestive association with Candida-related oral mucosal lesions in males (hazard ratio = 1.56, 95% CI: 0.92, 2.65; P = 0.098). Use of snus is associated with a lower risk of PD in males, while poor oral health seems not to be associated with PD occurrence.
很少有研究调查瑞典湿鼻烟（snus）的使用、相关的口腔健康不佳与帕金森病（PD）风险之间的关联。我们对1973年至1974年在瑞典乌普萨拉无PD的20175名参与者进行了随访，直至2012年底。我们使用Cox比例风险回归模型来估计烟草使用、口腔健康指标与PD风险之间关联的风险比及相应的95%置信区间。我们发现，烟草使用与男性较低的PD风险相关。与从不每日使用任何烟草的男性相比，单纯曾经吸烟的男性、单纯曾经使用鼻烟的男性以及两种都使用的男性，其调整后的风险比分别为0.68（95%置信区间（CI）：0.49，0.93；n = 83）、0.51（95% CI：0.27，0.95；n = 11）和0.21（95% CI：0.07，0.67；n = 3）。牙齿数量、牙菌斑或可检测到的口腔黏膜病变与PD风险之间未观察到关联，尽管男性中念珠菌相关的口腔黏膜病变存在提示性关联（风险比 = 1.56，95% CI：0.92，2.65；P = 0.098）。使用鼻烟与男性较低的PD风险相关，而口腔健康不佳似乎与PD的发生无关。
