Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA.
Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA; GRECC & Neurology Service, VAAAHS, Ann Arbor, MI, 48105, USA; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease Research, Ann Arbor, MI, 48109, USA; University of Michigan Parkinson's Foundation Research Center of Excellence, USA.
Parkinsonism Relat Disord. 2024 Aug;125:107026. doi: 10.1016/j.parkreldis.2024.107026. Epub 2024 Jun 13.
We review the epidemiologic literature on potential protective and risk factors in Parkinson's Disease (PD). Prior research identified numerous possible protective and risk factors. Potential protective factors include tobacco abuse, physical activity, urate levels, NSAID use, calcium channel blocker use, statin use, and use of some α1-adrenergic antagonists. Some potential protective factors could be products of reverse causation, including increased serum urate, tobacco abuse, and coffee-tea-caffeine consumption. Potential risk factors include traumatic brain injury, pesticide exposure, organic solvent exposure, lead exposure, air pollution, Type 2 Diabetes, some dairy products, cardiovascular disease, and some infections including Hepatitis C, H. pylori, and COVID-19. Potential non-environmental risk factors include bipolar disorder, essential tremor, bullous pemphigoid, and inflammatory bowel disease. There is an inverse relationship with PD and risk of most cancers. Though many potential protective and risk factors for PD were identified, research has not yet led to unique, rigorous prevention trials or successful disease-modifying interventions. While efforts to reduce exposure to some industrial toxicants are well justified, PD incidence might be most effectively reduced by mitigation of risks, such as Type 2 Diabetes, air pollution, traumatic brain injury, or physical inactivity, that are general public health intervention targets.
我们回顾了帕金森病（PD）潜在保护和风险因素的流行病学文献。先前的研究确定了许多可能的保护和风险因素。潜在的保护因素包括吸烟、体力活动、尿酸水平、非甾体抗炎药使用、钙通道阻滞剂使用、他汀类药物使用和某些α1-肾上腺素能拮抗剂的使用。一些潜在的保护因素可能是反向因果关系的产物，包括血清尿酸增加、吸烟和咖啡-茶-咖啡因的摄入。潜在的风险因素包括头部创伤、农药暴露、有机溶剂暴露、铅暴露、空气污染、2 型糖尿病、某些乳制品、心血管疾病以及丙型肝炎、幽门螺杆菌和 COVID-19 等一些感染。潜在的非环境风险因素包括双相情感障碍、特发性震颤、大疱性类天疱疮和炎症性肠病。PD 与大多数癌症的风险呈反比关系。尽管已经确定了许多 PD 的潜在保护和风险因素，但研究尚未导致独特的、严格的预防试验或成功的疾病修饰干预。虽然减少接触某些工业有毒物质的努力是合理的，但通过减轻 2 型糖尿病、空气污染、头部创伤或缺乏体育锻炼等一般公共卫生干预目标的风险，可能最有效地降低 PD 的发病率。
