EAP Encants, Institut Català de la Salut, Barcelona, Spain.
Unitat de Suport a la Recerca, Ambit Barcelona Ciutat, Barcelona, Spain.
Joint Bone Spine. 2022 Nov;89(6):105402. doi: 10.1016/j.jbspin.2022.105402. Epub 2022 Apr 30.
High levels of serum urate has been associated to a neuroprotective effect in Parkinson's disease (PD) as an antioxidant agent. However, the relation between gout and PD remains contradictory.
To study if the neuroprotective effect of serum urate is maintained in patients with gout in a large urban Mediterranean population.
Primary care based matched case-control study, carried out using an electronic health record database from the public primary care health system of Barcelona. The database contains anonymous data from 1,520,934 patients. All patients, over 40 years old, with a new diagnostic record of PD, or a new prescription of dopaminergic drugs were included (incident cases). We randomly selected four controls for each case, matched by gender and age, with the frequency matching approach. Retrospective data of PD risk factors were also collected for each individual. A multivariate logistic regression model was used to evaluate the association of gout and PD, adjusted by the presence of other risk factors.
A new PD diagnosis was found in 17,629 individuals (incident diagnosis rate of 2.2 per 1000 individuals). Multivariate logistic regression model showed for gout: aOR=0.83 (0.76-0.91). When stratified by age, aOR for those under 75years was 0.99 (0.85-1.16) and 75 or over OR=0.77 (0.70-0.86). Dyslipidemia, hypertension and diabetes mellitus were associated with an increased risk of PD. Tobacco consumption was protective.
Our study, the first one made in a Mediterranean population, shows a PD protective effect of gout in both men and women over 75years old.
高水平的血清尿酸与帕金森病（PD）的神经保护作用有关，作为一种抗氧化剂。然而，痛风与 PD 之间的关系仍然存在争议。
在一个大型城市地中海人群中，研究痛风患者的血清尿酸的神经保护作用是否仍然存在。
这是一项基于初级保健的匹配病例对照研究，使用巴塞罗那公共初级保健卫生系统的电子健康记录数据库进行。该数据库包含来自 1520934 名患者的匿名数据。所有年龄在 40 岁以上、有新的 PD 诊断记录或多巴胺能药物新处方的患者（首发病例）都被纳入研究。我们随机选择了每个病例的 4 名对照者，通过性别和年龄进行频数匹配。还为每个个体收集了 PD 危险因素的回顾性数据。使用多变量逻辑回归模型来评估痛风与 PD 的关联，同时调整其他危险因素的存在。
在 17629 名个体中发现了新的 PD 诊断（发病率为每 1000 人 2.2 例）。多变量逻辑回归模型显示，痛风的比值比为 0.83（0.76-0.91）。按年龄分层，75 岁以下的比值比为 0.99（0.85-1.16），75 岁及以上的比值比为 0.77（0.70-0.86）。血脂异常、高血压和糖尿病与 PD 风险增加相关。吸烟则有保护作用。
我们的研究，首次在一个地中海人群中进行，表明痛风对 75 岁以上的男性和女性的 PD 具有保护作用。
