Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
J Parkinsons Dis. 2017;7(4):677-684. doi: 10.3233/JPD-171175.
Caffeine intake has been associated with a lower risk of Parkinson's disease (PD). This association is robust in men, but inconsistent in women due to a possible interaction with post-menopausal hormone (PMH) use.
To (1) evaluate the association between caffeine intake and PD risk and (2) assess potential effect modification of the association by PMH use among women.
We examined associations between caffeine intake and incident PD risk in the Nurses' Health Study (NHS) (N = 121,701 women) and the Health Professionals Follow-up Study (HPFS) (N = 51,529 men). Dietary data on coffee and caffeine from other sources were collected every four years using a validated semi-quantitative food frequency questionnaire for both cohorts. Information on lifestyle and incident PD diagnosis was updated biennially and PD diagnoses were confirmed by medical record review. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards models.
We documented a total of 1,219 PD cases over the follow-up period. The multivariable-adjusted HR comparing the highest to lowest quintile of caffeine intake was 0.50 (95% CI: 0.37, 0.68; Ptrend<0.0001) in the HPFS. Among women, there was a suggestion of an interaction between coffee intake and PMH use (P = 0.08). In the pooled analyses combining men and women who have never used PMH, the risk of PD was lower as coffee intake increased (Ptrend<0.001).
Our results support previous findings that increased caffeine intake may be associated with a decreased PD risk in men and women who have never used PMH.
咖啡因摄入与帕金森病（PD）的风险降低有关。这种关联在男性中是稳健的，但在女性中不一致，因为它可能与绝经后激素（PMH）的使用存在交互作用。
（1）评估咖啡因摄入与 PD 风险之间的关联，以及（2）评估 PMH 使用对女性中该关联的潜在修饰作用。
我们在护士健康研究（NHS）（N = 121701 名女性）和健康专业人员随访研究（HPFS）（N = 51529 名男性）中研究了咖啡因摄入与 PD 发病风险之间的关联。这两个队列都使用经过验证的半定量食物频率问卷，每四年收集一次关于咖啡和其他来源咖啡因的饮食数据。使用生活方式和 PD 发病的信息，每两年更新一次，并通过医疗记录审查确认 PD 诊断。我们使用 Cox 比例风险模型估计危险比（HR）和 95%置信区间（CI）。
在随访期间，我们共记录了 1219 例 PD 病例。多变量调整后的 HR 比较了最高和最低五分位咖啡因摄入量，在 HPFS 中为 0.50（95%CI：0.37，0.68；Ptrend<0.0001）。在女性中，咖啡摄入量和 PMH 使用之间存在交互作用的迹象（P = 0.08）。在从未使用过 PMH 的男性和女性的联合分析中，随着咖啡摄入量的增加，PD 的风险降低（Ptrend<0.001）。
我们的结果支持先前的发现，即对于从未使用过 PMH 的男性和女性，增加咖啡因摄入可能与 PD 风险降低有关。
