Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Neurol. 2021 Apr;268(4):1508-1516. doi: 10.1007/s00415-020-10324-5. Epub 2020 Dec 4.
Systemic inflammation may be implicated in the pathophysiology of Parkinson's disease (PD). Since PD occurs usually in later life, most studies of causal factors are conducted in older populations, so potentially important influences from early life cannot be adequately captured. We investigated whether the erythrocyte sedimentation rate (ESR) in early adulthood is associated with the subsequent development of PD in men. As part of Swedish national conscription testing conducted from 1968 through 1983 (N = 716,550), the erythrocyte sedimentation rate, as a measure of inflammation, was measured in 659,278 young men. The cohort was observed for subsequent PD events (N = 1513) through December 2016. Cox proportional hazards models were used to estimate the hazard ratios (HR) with 95% CI with adjustment for potential confounders. Individuals with higher ESRs were significantly less likely to be diagnosed with PD, as ESR was linearly and inversely associated with PD risk. The magnitude of the association between ESR and PD risk was similar for increases up to 15 mm/h, leveled off thereafter, and was non-significant for ESR values > 20 mm/h. The HR for PD with basic adjustments (age at conscription, year of conscription, test center and erythrocyte volume fraction) was 0.94 (95% CI 0.89-0.99, P = 0.02) per log increase in ESR, corresponding to a two-fold increase in ESR. Further adjustments for potential confounders (parental education, systolic and diastolic blood pressures, and IQ) scarcely altered the HR. The results suggest a prospective association between high ESR and reduced risk for PD.
系统炎症可能与帕金森病 (PD) 的病理生理学有关。由于 PD 通常发生在晚年，因此大多数因果因素的研究都是在老年人中进行的，因此无法充分捕捉到来自早期生活的潜在重要影响。我们研究了成年早期的红细胞沉降率 (ESR) 是否与男性随后发生 PD 有关。作为瑞典国家兵役测试的一部分，该测试于 1968 年至 1983 年进行（N=716550），在 659278 名年轻男性中测量了红细胞沉降率作为炎症的衡量标准。该队列观察了随后的 PD 事件（N=1513）直至 2016 年 12 月。使用 Cox 比例风险模型估计了调整潜在混杂因素后的风险比 (HR) 和 95%CI。ESR 较高的个体患 PD 的可能性明显降低，因为 ESR 与 PD 风险呈线性反比关系。ESR 与 PD 风险之间的关联幅度在增加至 15 mm/h 时相似，此后趋于平稳，ESR 值>20 mm/h 时则不显著。基本调整（入伍年龄、入伍年份、测试中心和红细胞体积分数）后的 PD 风险 HR 为 0.94（95%CI 0.89-0.99，P=0.02）每对数 ESR 增加，ESR 增加一倍。进一步调整潜在混杂因素（父母教育程度、收缩压和舒张压以及智商）几乎没有改变 HR。结果表明 ESR 升高与 PD 风险降低之间存在前瞻性关联。
