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青年智力、教育、身高和体重指数与帕金森病发病风险和生存的关联:一项丹麦队列研究。

Associations of Young Adult Intelligence, Education, Height, and Body Mass Index with Subsequent Risk of Parkinson's Disease and Survival: A Danish Cohort Study.

机构信息

Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark.

Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Parkinsons Dis. 2022;12(3):1035-1043. doi: 10.3233/JPD-213102.

Abstract

BACKGROUND

The underlying disease mechanisms of Parkinson's disease (PD) are still unknown and knowledge about risk and prognostic factors is sparse.

OBJECTIVE

To examine the association between intelligence, education, body height, and body mass index (BMI) in young adulthood and risk of PD and subsequent survival.

METHODS

In total, 656,751 men born 1939-1959 with information from conscription examinations around age 19 years were followed for PD and mortality from 1977-2018 in Danish registries. Cox proportional hazard regression was used to conduct the analyses.

RESULTS

During follow-up, 5,264 (0.8%) men were diagnosed with PD. Higher intelligence, education, and body height conferred a higher hazard of PD, independent of age at disease onset. BMI above compared to below the mean (22.8 kg/m2) was associated with slightly higher hazard of late-onset PD (>60 years). During follow-up, 2,125 (40.5%) men with PD died, corresponding to a 2.55 (95% confidence interval:2.44-2.66) times higher mortality compared to men without PD. Intelligence was inversely associated with mortality in men with and without PD. Higher education and body height were also inversely associated with mortality in men without PD, whereas the estimates were less pronounced and imprecisely estimated for men with PD. Having an obese BMI was associated with higher mortality in men with PD.

CONCLUSION

Intelligence, education, and body height in young adulthood are positively associated with risk of PD later in life among men. BMI above the mean only confer a higher risk for late-onset PD. For men diagnosed with PD, high intelligence is the only early life indicator associated with better survival, whereas obese BMI predicts poorer survival.

摘要

背景

帕金森病(PD)的潜在发病机制尚不清楚,有关风险和预后因素的知识也很匮乏。

目的

研究年轻时的智力、教育程度、身高和体重指数(BMI)与 PD 风险和后续生存的关系。

方法

共有 656751 名 1939-1959 年出生的男性参加了兵役检查,在丹麦的登记处从 1977 年至 2018 年进行了 PD 和死亡率的随访。使用 Cox 比例风险回归进行分析。

结果

在随访期间,有 5264 名(0.8%)男性被诊断为 PD。较高的智力、教育程度和身高与 PD 的发病风险增加独立相关,与发病年龄无关。与平均水平(22.8kg/m2)相比,BMI 高于或低于平均水平与晚发性 PD(>60 岁)的发病风险略高有关。在随访期间,有 2125 名(40.5%)PD 患者死亡,与没有 PD 的男性相比,死亡率高出 2.55 倍(95%置信区间:2.44-2.66)。在有和没有 PD 的男性中,智力与死亡率呈负相关。在没有 PD 的男性中,较高的教育程度和身高也与死亡率呈负相关,而在 PD 患者中,这些估计值的幅度较小且精度较低。肥胖的 BMI 与 PD 患者的死亡率较高有关。

结论

年轻时的智力、教育程度和身高与男性晚年 PD 的发病风险呈正相关。BMI 高于平均水平仅与晚发性 PD 的风险增加有关。对于被诊断为 PD 的男性,高智力是唯一与生存状况较好相关的早期生命指标,而肥胖的 BMI 预示着较差的生存状况。

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