Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Brain Innovations Lab, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128, Rome, Italy.
Operative Research Unit of Neurology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy; Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Roma, Italy.
Parkinsonism Relat Disord. 2024 Aug;125:107022. doi: 10.1016/j.parkreldis.2024.107022. Epub 2024 May 28.
Epidemiological studies have consistently shown an inverse association between cigarette smoking and Parkinson's disease. Literature indicates that both current and former smokers have a reduced risk of developing PD compared to non-smokers. If smoking protects against Parkinson's disease risk or, conversely, smoking habit is abated due to the disease itself, according to the reverse causation, is still an unsolved question.
118 patients from the UK Brain Bank with an alive clinical diagnosis of Parkinson's disease were enrolled. Post-mortem validation served as the gold standard for diagnosis to divide the population into true positive and false positive groups. Patient charts were reviewed to extract smoking exposure information and statistical analyses were conducted to determine the odds associated with smoking in the two diagnostic groups.
Among alive clinically diagnosed patients with Parkinson's disease, 53 % had no smoking exposure. In the True Positive group, 58 % had no smoking exposure, while this proportion was lower in the False Positive group at 46 %. The Odds Ratio for the association between smoking exposure and the two groups was 0.63 (95 % CI: 0.32-1.37). The Chi-square test yielded a p-value of 0.2804.
Our findings emphasize the role of smoking exposure in Parkinson's diagnosis. The results indicate that the observed association is not specific to idiopathic Parkinson's disease but rather a broader phenomenon encompassing various parkinsonian disorders. This suggests a potential common neuroprotective effect of smoking, shared risk factors, or supports the reverse causation hypothesis where parkinsonian symptoms reduce smoking exposure.
流行病学研究一致表明，吸烟与帕金森病之间存在负相关关系。文献表明，与不吸烟者相比，当前吸烟者和曾经吸烟者患 PD 的风险降低。如果吸烟能降低帕金森病的风险，或者相反，由于疾病本身，吸烟习惯减轻，根据反向因果关系，这仍然是一个悬而未决的问题。
从英国脑库招募了 118 名患有帕金森病的存活临床诊断患者。死后验证作为诊断的金标准，将人群分为真阳性和假阳性组。查阅病历以提取吸烟暴露信息，并进行统计分析，以确定与两组诊断相关的吸烟几率。
在患有帕金森病的存活临床诊断患者中，53%没有吸烟暴露。在真阳性组中，58%没有吸烟暴露，而在假阳性组中，这一比例较低，为 46%。吸烟暴露与两组之间的关联的优势比为 0.63（95%置信区间：0.32-1.37）。卡方检验的 p 值为 0.2804。
我们的发现强调了吸烟暴露在帕金森病诊断中的作用。结果表明，观察到的关联不仅限于特发性帕金森病，而是更广泛的涵盖各种帕金森病的现象。这表明吸烟具有潜在的共同神经保护作用、共同的风险因素，或者支持反向因果关系假说，即帕金森病症状减少吸烟暴露。
