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他汀类药物可能会促进帕金森病的发展:来自一个大型国家索赔数据库的见解。

Statins may facilitate Parkinson's disease: Insight gained from a large, national claims database.

作者信息

Liu Guodong, Sterling Nicholas W, Kong Lan, Lewis Mechelle M, Mailman Richard B, Chen Honglei, Leslie Douglas, Huang Xuemei

机构信息

Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.

Department of Neurology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.

出版信息

Mov Disord. 2017 Jun;32(6):913-917. doi: 10.1002/mds.27006. Epub 2017 Apr 3.

Abstract

OBJECTIVE

Using a large U.S. claims database (MarketScan), we investigated the controversy surrounding the role of statins in Parkinson's disease (PD).

METHODS

We performed a retrospective case-control analysis. First, we identified 2322 incident PD cases having a minimum of 2.5 years of continuous enrollment prior to earliest diagnosis code or prescription of antiparkinson medication. A total of 2322 controls were then matched individually by age, gender, and a follow-up window to explore the relationship of statin use with incident PD.

RESULTS

Statin usage was significantly associated with PD risk, with the strongest associations being for lipophilic (odds ratio = 1.58, P < .0001) versus hydrophilic (odds ratio = 1.19, P = .25) statins, statins plus nonstatins (odds ratio = 1.95, P < .0001), and for the initial period after starting statins (<1 year odds ratio = 1.82, 1-2.5 years odds ratio = 1.75, and ≥2.5 years odds ratio = 1.37; P < .0001).

CONCLUSION

The use of statin (especially lipophilics) was associated with higher risk of PD, and the stronger association in initial use suggests a facilitating effect. © 2017 International Parkinson and Movement Disorder Society.

摘要

目的

利用一个大型美国索赔数据库(MarketScan),我们调查了围绕他汀类药物在帕金森病(PD)中作用的争议。

方法

我们进行了一项回顾性病例对照分析。首先,我们确定了2322例新发PD病例,这些病例在最早诊断代码或抗帕金森药物处方之前至少连续登记2.5年。然后,根据年龄、性别和随访窗口分别匹配2322名对照,以探讨他汀类药物使用与新发PD之间的关系。

结果

他汀类药物的使用与PD风险显著相关,最强的关联是亲脂性他汀(比值比=1.58,P<.0001)与亲水性他汀(比值比=1.19,P=.25)、他汀类药物加非他汀类药物(比值比=1.95,P<.0001),以及开始使用他汀类药物后的初始阶段(<1年比值比=1.82,1 - 2.5年比值比=1.75,≥2.5年比值比=1.37;P<.0001)。

结论

他汀类药物(尤其是亲脂性药物)的使用与较高的PD风险相关,且初始使用时更强的关联表明有促进作用。©2017国际帕金森和运动障碍协会。

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