帕金森病与心血管疾病死亡率的关联：来自 NHANES 的前瞻性基于人群的研究。

Association between Parkinson's disease and cardiovascular disease mortality: a prospective population-based study from NHANES.

机构信息

Department of Neurology, Suining Central Hospital, Suining, Sichuan Province, China.

Department of Neurology, Nanxishan Hospital, Nanning, Guangxi Zhuang Autonomous Region, China.

出版信息

Lipids Health Dis. 2024 Jul 4;23(1):212. doi: 10.1186/s12944-024-02200-2.

DOI:10.1186/s12944-024-02200-2

PMID:38965560

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11223358/

Abstract

BACKGROUND AND AIM

Conflicting results have been reported on the association between Parkinson's disease (PD) and cardiovascular disease (CVD) mortality in different populations. Therefore, studying the relationship between PD and CVD mortality is crucial to reduce mortality caused by the former.

METHODS

In this cohort investigation, we enrolled 28,242 participants from the National Health and Nutrition Examination Survey spanning from 2003 to 2018. The 380 cases of PD in the cohort were identified by documenting 'ANTIPARKINSON AGENTS' in their reported prescription medications. Mortality outcomes were ascertained by cross-referencing the cohort database with the National Death Index, which was last updated on 31 December 2019. Cardiovascular disease mortality was categorised according to the 10th revision of the International Classification of Diseases by using a spectrum of diagnostic codes. Weighted multivariable Cox regression analysis was used to examine the association between PD and the risk of CVD mortality.

RESULTS

A total of 28,242 adults were included in the study [mean age, 60.156 (12.55) years, 13,766 men (48.74%)], and the median follow-up period was 89 months. Individuals with PD had an adjusted HR of 1.82 (95% CI, 1.24-2.69; p = 0.002) for CVD mortality and 1.84 (95% CI, 1.44-2.33; p < 0.001) for all-cause mortality compared with those without PD. The association between PD and CVD mortality was robust in sensitivity analyses, after excluding participants who died within 2 years of follow-up and those with a history of cancer at baseline [HR,1.82 (95% CI, 1.20-2.75; p = 0.005)].

CONCLUSIONS

PD was associated with a high long-term CVD mortality rate in the US population.

摘要

背景与目的

不同人群中帕金森病（PD）与心血管疾病（CVD）死亡率之间的关联结果存在差异。因此，研究 PD 与 CVD 死亡率之间的关系对于降低前者导致的死亡率至关重要。

方法

在这项队列研究中，我们纳入了 2003 年至 2018 年期间参加国家健康和营养检查调查的 28242 名参与者。队列中的 380 例 PD 病例通过记录报告的处方药物中的“抗帕金森药物”来确定。通过将队列数据库与截至 2019 年 12 月 31 日最后更新的国家死亡指数交叉引用来确定死亡率结局。心血管疾病死亡率根据国际疾病分类第 10 版的诊断代码范围进行分类。使用加权多变量 Cox 回归分析来检查 PD 与 CVD 死亡率风险之间的关联。

结果

共纳入 28242 名成年人（平均年龄 60.156（12.55）岁，男性 13766 人[48.74%]），中位随访时间为 89 个月。与无 PD 者相比，PD 患者 CVD 死亡率的校正 HR 为 1.82（95%CI，1.24-2.69；p=0.002），全因死亡率的校正 HR 为 1.84（95%CI，1.44-2.33；p<0.001）。在排除随访 2 年内死亡的参与者和基线时有癌症病史的参与者后，PD 与 CVD 死亡率之间的关联在敏感性分析中仍然稳健[HR，1.82（95%CI，1.20-2.75；p=0.005)]。