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前瞻性研究前驱期、临床帕金森病与肺功能及死亡率。

Prospective Study of Lung Function with Prodromal, Clinical Parkinson's Disease, and Mortality.

机构信息

Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

J Parkinsons Dis. 2024;14(7):1427-1439. doi: 10.3233/JPD-240097.

Abstract

BACKGROUND

The association of lung function with the risk of developing prodromal and clinical-diagnosed Parkinson's disease (PD) and with the risk of mortality among individuals with PD remains unknown.

OBJECTIVE

To prospectively examine the associations of lung function with the risk of prodromal, clinical-diagnosed PD, and PD-related mortality in participants of the UK Biobank.

METHODS

Included were 452,518 participants free of PD at baseline. Baseline lung function, including forced expiratory volume in 1-s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and FEV1/FVC ratio, was assessed. Eight prodromal features were measured using self-reported diagnoses, hospital admission, and primary care data. Incident PD cases were identified using linkages with hospital admission, death register, and self-report. Vital status and date of death were provided by the UK National Health Service (NHS) and the NHS Central Register. We used Cox proportional hazard models to evaluate these associations.

RESULTS

Poor lung function was associated with higher risk of PD in a dose-response relationship: the adjusted hazard ratio comparing the lowest vs. the highest lung function quintile was 1.18 (95% CI, 1.02- 1.37) for FEV1, 1.14 (95% CI, 0.99- 1.29) for FVC, and 1.23 (95% CI, 1.08- 1.41) for PEF (p-trend <0.05 for all). Similar results were obtained for risk of prodromal PD and mortality among individuals with PD.

CONCLUSIONS

The current study showed that individuals with poor lung function had a high future risk of prodromal and clinical PD and a higher rate of PD-related mortality.

摘要

背景

肺功能与前驱期和临床诊断帕金森病(PD)风险以及 PD 患者死亡率的关系尚不清楚。

目的

前瞻性研究英国生物银行参与者的肺功能与前驱期、临床诊断 PD 以及 PD 相关死亡率的关系。

方法

纳入 452518 名基线时无 PD 的参与者。评估基线肺功能,包括 1 秒用力呼气量(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF)和 FEV1/FVC 比值。使用自我报告的诊断、住院和初级保健数据测量了 8 种前驱期特征。通过与住院、死亡登记和自我报告的关联来确定 PD 病例。通过英国国家卫生服务(NHS)和 NHS 中央登记处提供生命状态和死亡日期。我们使用 Cox 比例风险模型评估这些关联。

结果

肺功能差与 PD 风险呈剂量-反应关系:最低与最高肺功能五分位组相比,FEV1、FVC 和 PEF 的调整后的危险比分别为 1.18(95%CI,1.02-1.37)、1.14(95%CI,0.99-1.29)和 1.23(95%CI,1.08-1.41)(p 趋势<0.05)。在 PD 前驱期和 PD 患者死亡率方面也得到了类似的结果。

结论

本研究表明,肺功能差的个体未来患前驱期和临床 PD 的风险较高,PD 相关死亡率也较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d810/11492123/8be901a43189/jpd-14-jpd240097-g001.jpg

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