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日本老年人使用他汀类药物与帕金森病风险:一项基于长寿改善与公平证据研究的巢式病例对照研究

Statin use and risk of Parkinson's disease among older adults in Japan: a nested case-control study using the Longevity Improvement and Fair Evidence study.

作者信息

Ge Sanyu, Zha Ling, Kimura Yasuyoshi, Shimomura Yoshimitsu, Komatsu Masayo, Gon Yasufumi, Komukai Sho, Murata Fumiko, Maeda Megumi, Kiyohara Kosuke, Sobue Tomotaka, Kitamura Tetsuhisa, Fukuda Haruhisa

机构信息

Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, 565-0871, Osaka, Japan.

Department of Neurology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan.

出版信息

Brain Commun. 2024 Jun 4;6(3):fcae195. doi: 10.1093/braincomms/fcae195. eCollection 2024.

Abstract

The association between statin use and the risk of Parkinson's disease remains inconclusive, particularly in Japan's super-ageing society. This study aimed to investigate the potential association between statin use and the risk of Parkinson's disease among Japanese participants aged ≥65 years. We used data from the Longevity Improvement and Fair Evidence Study, which included medical and long-term care claim data from April 2014 to December 2020 across 17 municipalities. Using a nested case-control design, we matched one case to five controls based on age, sex, municipality and cohort entry year. A conditional logistic regression model was used to estimate the odds ratios with 95% confidence intervals. Among the 56 186 participants (9397 cases and 46 789 controls), 53.6% were women. The inverse association between statin use and Parkinson's disease risk was significant after adjusting for multiple variables (odds ratio: 0.61; 95% confidence interval: 0.56-0.66). Compared with non-users, the dose analysis revealed varying odds ratios: 1.30 (1.12-1.52) for 1-30 total standard daily doses, 0.77 (0.64-0.92) for 31-90 total standard daily doses, 0.62 (0.52-0.75) for 91-180 total standard daily doses and 0.30 (0.25-0.35) for >180 total standard daily doses. Statin use among older Japanese adults was associated with a decreased risk of Parkinson's disease. Notably, lower cumulative statin doses were associated with an elevated risk of Parkinson's disease, whereas higher cumulative doses exhibited protective effects against Parkinson's disease development.

摘要

他汀类药物的使用与帕金森病风险之间的关联尚无定论,尤其是在日本的超老龄化社会中。本研究旨在调查年龄≥65岁的日本参与者中,他汀类药物的使用与帕金森病风险之间的潜在关联。我们使用了长寿改善与公平证据研究的数据,其中包括2014年4月至2020年12月期间17个市的医疗和长期护理理赔数据。采用巢式病例对照设计,我们根据年龄、性别、市和队列进入年份,将1例病例与5例对照进行匹配。使用条件逻辑回归模型来估计比值比及95%置信区间。在56186名参与者(9397例病例和46789例对照)中,53.6%为女性。在对多个变量进行调整后,他汀类药物的使用与帕金森病风险之间的负相关具有显著性(比值比:0.61;95%置信区间:0.56 - 0.66)。与未使用者相比,剂量分析显示出不同的比值比:总标准日剂量为1 - 30时为1.30(1.12 - 1.52),31 - 90时为0.77(0.64 - 0.92),91 - 180时为0.62(0.52 - 0.75),大于180时为0.30(0.25 - 0.35)。日本老年成年人使用他汀类药物与帕金森病风险降低相关。值得注意的是,较低的他汀类药物累积剂量与帕金森病风险升高相关,而较高的累积剂量对帕金森病的发展具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bd7/11184346/9ed92438d955/fcae195_ga.jpg

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