Hughes Katherine C, Gao Xiang, Baker Jessica M, Stephen Christopher D, Kim Iris Y, Valeri Linda, Schwarzschild Michael A, Ascherio Alberto
Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Nutritional Health, The Pennsylvania State University, University Park, PA, USA.
J Parkinsons Dis. 2021;11(3):1237-1246. doi: 10.3233/JPD-202409.
Non-motor symptoms are common in Parkinson's disease (PD) and some, including hyposmia, constipation, and REM sleep behavior disorder, often precede the clinical diagnosis.
To assess the relation between combinations of non-motor features and presence of PD among women.
A nested case-control study was conducted among women in the Nurses' Health Study. Women were eligible if they responded to screening questions for constipation and probable REM sleep behavior disorder (pRBD) on a 2012 questionnaire and were under age 85 on January 1, 2012. 87 women with confirmed PD and 14,170 women without PD agreed to participate and completed in 2015 the Brief Smell Identification Test to assess hyposmia, as well as a questionnaire to assess parkinsonism and other non-motor PD features, including depressive symptoms, excessive daytime sleepiness, impaired color vision, and body pain.
In age-adjusted logistic models, each non-motor feature was significantly associated with PD, and the odds of PD increased exponentially with the number of features. Women with constipation, pRBD, and hyposmia had an age-adjusted OR for PD of 211 (95% CI 84.2-529) compared to women with none of these features. The odds of having PD rose further with the presence of additional non-motor signs. Comparing women with at least 6 of the 7 features assessed in this study to women with one or none, the age-adjusted OR for PD was 356 (95% CI 113-1126).
Results suggest that these non-motor features could be useful in discriminating PD patients from controls in women, and since they often appear during the prodromal period of PD, their combinations may prove useful for identifying populations at high risk of developing PD.
非运动症状在帕金森病（PD）中很常见，其中一些症状，包括嗅觉减退、便秘和快速眼动睡眠行为障碍，通常在临床诊断之前出现。
评估女性中非运动特征组合与帕金森病存在之间的关系。
在护士健康研究中的女性中进行了一项巢式病例对照研究。如果女性在2012年问卷中对便秘和可能的快速眼动睡眠行为障碍（pRBD）筛查问题有回应，并且在2012年1月1日年龄在85岁以下，则符合条件。87名确诊为帕金森病的女性和14170名未患帕金森病的女性同意参与，并于2015年完成了简易嗅觉识别测试以评估嗅觉减退，以及一份问卷以评估帕金森综合征和其他非运动性帕金森病特征，包括抑郁症状、日间过度嗜睡、色觉受损和身体疼痛。
在年龄调整的逻辑模型中，每个非运动特征都与帕金森病显著相关，并且帕金森病的几率随着特征数量呈指数增加。与没有这些特征的女性相比，患有便秘、pRBD和嗅觉减退的女性经年龄调整后的帕金森病比值比为211（95%可信区间84.2 - 529）。随着其他非运动体征的出现，患帕金森病的几率进一步上升。将本研究中评估的7项特征中至少有6项的女性与有1项或没有特征的女性进行比较，经年龄调整后的帕金森病比值比为356（95%可信区间113 - 1126）。
结果表明，这些非运动特征可能有助于在女性中将帕金森病患者与对照区分开来，并且由于它们经常在帕金森病的前驱期出现，它们的组合可能被证明有助于识别有患帕金森病高风险的人群。
