Yoon Seo Yeon, Heo Seok-Jae, Kim Yong Wook, Yang Seung Nam, Moon Hyun Im
Department of Physical Medicine & Rehabilitation, Korea University Guro Hospital, Seoul, Republic of Korea.
Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, Republic of Korea.
J Parkinsons Dis. 2022;12(1):353-360. doi: 10.3233/JPD-212878.
Ankylosing spondylitis (AS) is an immune-mediated, chronic inflammatory rheumatic disorder. The etiology of Parkinson's disease (PD) is multifactorial; however, inflammation is receiving an increasing amount of attention as an underlying cause of the neurodegenerative process of PD.
We performed a nationwide longitudinal, population-based matched cohort study to assess the association with the later development of parkinsonism in Korea.
This study was conducted using records from the Health Insurance Review and Assessment Service database. The cumulative incidence rate of PD was estimated. Fine-Gray subdistribution hazard models were used to identify hazards associated with PD development based on the presence of AS. Exposure to anti-inflammatory drugs was measured and analyzed to determine the protective effect of these medications. Additionally, the hazard ratio (HR) for atypical parkinsonism was estimated.
The results of the Fine-Gray subdistribution hazard model revealed that the HR for PD development in the AS group was 1.82 (95%confidence interval [CI], 1.38-2.39, p < 0.001). A significant decrease in PD development was observed in patients with AS taking non-steroidal anti-inflammatory drugs (NSAIDs). The HR for atypical parkinsonism in the AS group was 3.86 (95%CI, 1.08-13.78, p < 0.05).
We found that AS was associated with an increased risk of PD and atypical parkinsonism. NSAIDs used for AS control have some protective effects against PD. Further studies assessing whether biological treatment mitigates PD risk in patients with high activity are warranted.
强直性脊柱炎(AS)是一种免疫介导的慢性炎症性风湿性疾病。帕金森病(PD)的病因是多因素的;然而,炎症作为PD神经退行性过程的潜在原因正受到越来越多的关注。
我们进行了一项全国性的纵向、基于人群的匹配队列研究,以评估韩国AS与帕金森综合征后期发展的关联。
本研究使用了健康保险审查和评估服务数据库中的记录。估计了PD的累积发病率。采用Fine-Gray亚分布风险模型,根据AS的存在情况确定与PD发展相关的风险因素。测量并分析抗炎药物的使用情况,以确定这些药物的保护作用。此外,还估计了非典型帕金森综合征的风险比(HR)。
Fine-Gray亚分布风险模型的结果显示,AS组发生PD的HR为1.82(95%置信区间[CI],1.38-2.39,p<0.001)。服用非甾体抗炎药(NSAIDs)的AS患者发生PD的情况显著减少。AS组非典型帕金森综合征的HR为3.86(95%CI,1.08-13.78,p<0.05)。
我们发现AS与PD和非典型帕金森综合征的风险增加有关。用于控制AS的NSAIDs对PD有一定的保护作用。有必要进一步研究评估生物治疗是否能降低高活动度患者的PD风险。