1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece; Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Greece.
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece.
Parkinsonism Relat Disord. 2019 Oct;67:105-112. doi: 10.1016/j.parkreldis.2019.08.013. Epub 2019 Aug 26.
The aim of this study is to investigate the association between environmental factors (smoking, coffee, pesticide exposure) and Parkinson's disease (PD) subtypes (early-onset, mid-and-late onset, familial and sporadic) in the Greek population.
The Hellenic Biobank of PD recorded information of PD cases and controls from two centers in Greece during 2006-2017. Patients with the A53T mutation in SNCA or GBA mutations were excluded. Associations of environmental factors with PD overall (and PD subtypes) versus controls were explored with logistic regression models adjusting for age, gender and each environmental factor.
686 patients and 356 controls were included. Smoking was associated with a reduced risk of PD overall (OR 0.48, 95% CI 0.35-0.67), mid-and-late onset (0.46, 0.32-0.66), familial (0.53, 0.34-0.83) and sporadic (0.46, 0.32-0.65), but not early-onset PD. There was an inverse linear association with pack-years of smoking, except for early-onset PD. Early-onset PD was the only PD subtype inversely associated with coffee consumption when dichotomously treated. Compared to never-coffee drinkers, only those at the upper tertile had lower odds for PD overall (0.52, 0.29-0.91), early-onset (0.16, 0.05-0.53) and familial PD (0.36, 0.17-0.75). No associations were found between pesticides and PD.
Our study shows that the well-known negative association of smoking with PD occurs across all PD subtypes in the Greek population, apart from early-onset PD. Early-onset PD was also most strongly inversely associated with coffee consumption, highlighting a potential distinct underlying physiopathology in this PD subset that may involve specific gene-environment interactions.
本研究旨在探讨环境因素（吸烟、咖啡、农药暴露）与希腊人群帕金森病（PD）亚型（早发型、中晚期发病、家族性和散发性）之间的关联。
希腊 PD 生物银行记录了 2006 年至 2017 年间希腊两个中心的 PD 病例和对照者的信息。排除携带 SNCA A53T 突变或 GBA 突变的患者。采用 logistic 回归模型，调整年龄、性别和每个环境因素，探讨环境因素与 PD 整体（和 PD 亚型）与对照者的关系。
纳入 686 例患者和 356 例对照者。吸烟与 PD 整体（OR 0.48，95%CI 0.35-0.67）、中晚期发病（0.46，0.32-0.66）、家族性（0.53，0.34-0.83）和散发性（0.46，0.32-0.65）发病呈负相关，但与早发型 PD 无关。吸烟包年数呈负相关，但早发型 PD 除外。早发型 PD 是唯一与咖啡摄入呈负相关的 PD 亚型，当咖啡摄入分为二分类时。与从不喝咖啡者相比，只有饮用咖啡量在上 tertile 的人患 PD 整体（0.52，0.29-0.91）、早发型（0.16，0.05-0.53）和家族性 PD（0.36，0.17-0.75）的几率更低。未发现农药与 PD 之间存在关联。
本研究表明，在希腊人群中，除早发型 PD 外，吸烟与 PD 的负相关在所有 PD 亚型中均存在。早发型 PD 也与咖啡摄入呈最强负相关，突出了这一 PD 亚组中潜在的不同发病机制，可能涉及特定的基因-环境相互作用。
