Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Mov Disord. 2019 Jul;34(7):1014-1021. doi: 10.1002/mds.27681. Epub 2019 Apr 2.
There have been conflicting results on the association between statin use and Parkinson's disease (PD) incidence.
This study investigated the association between time-varying status of statin use and incidence of PD while considering the dose-response relationship and total cholesterol level.
Using the database of the Korean National Health Insurance Service from 2002 to 2015, we examined 76,043 subjects (≥60 years old) free of PD, dementia, and stroke at baseline. The dose of statin use was classified into the following four 6-month categories (<180, 180-365, 365-540, and ≥540 days) for each 2-year interval. The incidence of PD was identified by the prescription records for any anti-PD medication with a diagnosis of PD.
During 10 years of follow-up, 1,427 PD cases occurred. Statin "ever use" was significantly associated with a high risk of PD incidence (adjusted hazard ratio = 1.28; 95% confidence interval = 1.12-1.46) when compared with statin nonuse. In terms of a dose-response relationship, although a duration of statin use <365 days was associated with a higher risk of PD, the duration of statin use ≥365 days was not significantly associated with an increased risk of PD.
Statin use was associated with an elevated PD risk of PD, but long-term and adherent statin use was not significantly associated with elevated PD risk. However, there was no evidence of benefit with any statin treatment related to PD risk. Our study suggests that there is a complex relationship among cholesterol level, statin use, and PD risk that warrants further studies. © 2019 International Parkinson and Movement Disorder Society.
他汀类药物使用与帕金森病（PD）发病率之间的关联结果存在冲突。
本研究调查了他汀类药物使用的时变状态与 PD 发病率之间的关联，同时考虑了剂量-反应关系和总胆固醇水平。
使用 2002 年至 2015 年韩国国家健康保险服务数据库，我们检查了 76043 名（≥60 岁）基线时无 PD、痴呆和中风的受试者。他汀类药物使用的剂量分为以下四个 6 个月类别（<180、180-365、365-540 和≥540 天），每个 2 年间隔一次。PD 的发病率通过任何抗 PD 药物的处方记录来确定，这些药物都有 PD 的诊断。
在 10 年的随访期间，发生了 1427 例 PD 病例。与他汀类药物不使用者相比，他汀类药物“曾经使用”与 PD 发病率高风险显著相关（调整后的危险比=1.28；95%置信区间=1.12-1.46）。就剂量-反应关系而言，尽管他汀类药物使用时间<365 天与 PD 风险增加相关，但他汀类药物使用时间≥365 天与 PD 风险增加无关。
他汀类药物使用与 PD 风险增加相关，但长期和坚持使用他汀类药物与 PD 风险增加无关。然而，没有证据表明任何与他汀类药物治疗相关的治疗与 PD 风险有关。我们的研究表明，胆固醇水平、他汀类药物使用和 PD 风险之间存在复杂的关系，需要进一步研究。© 2019 国际帕金森病和运动障碍学会。
