Hong Chien Tai, Hu Han-Hwa, Chan Lung, Bai Chyi-Huey
Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,
Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan,
Clin Epidemiol. 2018 Sep 4;10:1147-1154. doi: 10.2147/CLEP.S163493. eCollection 2018.
People with Parkinson's disease (PwP) are speculated to be at a low risk of cerebrovascular and cardiovascular disease (CVD) because they have fewer vascular risk factors and lower smoking rate. However, emerging evidence suggests that PwP are at higher risk of CVD, which introduces controversy to the notion that there is no association between Parkinson's disease (PD) and CVD. Hence, we conducted a meta-analysis to analyze the risk of CVD in PwP.
Electronic databases were searched using terms related to PD and CVD. Articles were included in the meta-analysis only if they employed clear diagnostic criteria for PD and CVD. The reference lists of the relevant articles were reviewed to identify eligible studies not found during the keyword search.
The enrolled studies were categorized into case-control and cohort studies, and the former was further divided into postmortem (three) and clinical (four) studies. In the clinical case-control studies group, PD was more associated with CVD (OR: 2.89, 95% CI: 1.36-6.13). Three studies were enrolled in the cohort studies group, and the merged results demonstrated that PwP were at higher risk of CVD during the follow-up period (HR: 1.84, 95% CI: 1.34-2.54).
PD is associated with CVD, which may be due to the shared pathogeneses between the two diseases or PD-related effects. PwP should be more aware of the risk of CVD despite having fewer traditional vascular risk factors.
帕金森病患者(PwP)被推测患脑血管和心血管疾病(CVD)的风险较低,因为他们的血管危险因素较少且吸烟率较低。然而,新出现的证据表明PwP患CVD的风险更高,这给帕金森病(PD)与CVD之间不存在关联的观点带来了争议。因此,我们进行了一项荟萃分析,以分析PwP患CVD的风险。
使用与PD和CVD相关的术语检索电子数据库。只有当文章采用明确的PD和CVD诊断标准时,才纳入荟萃分析。对相关文章的参考文献列表进行审查,以识别在关键词搜索期间未找到的合格研究。
纳入的研究分为病例对照研究和队列研究,前者进一步分为尸检研究(三项)和临床研究(四项)。在临床病例对照研究组中,PD与CVD的关联更强(OR:2.89,95%CI:1.36 - 6.13)。队列研究组纳入了三项研究,合并结果表明PwP在随访期间患CVD的风险更高(HR:1.84,95%CI:1.34 - 2.54)。
PD与CVD相关,这可能是由于两种疾病之间的共同发病机制或与PD相关的影响。尽管PwP的传统血管危险因素较少,但他们应更加注意CVD的风险。