Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, No.157 Daming Road, Nanjing, 210022, People's Republic of China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China.
J Neurol. 2024 Dec;271(12):7434-7459. doi: 10.1007/s00415-024-12672-y. Epub 2024 Oct 3.
Although recent meta-analyses have shown that the association between physical activity (PA) and the risk of developing Parkinson's disease (PD) is influenced by gender differences, a growing number of studies are revealing the general applicability of this association across genders. This study aimed to reassess the association and dose-response relationship between PA and PD risk in populations.
A systematic search of PubMed, Embase, Cochrane Library, and Web of Science databases was conducted in this study from inception to February 1, 2024, without language restrictions. Stratified analyses were conducted to explore the association between PA and PD risk, combining multivariate-adjusted effect estimates via random-effects models, and to validate the dose-response relationship between the two.
This study included 21 observational studies, comprising 13 cohort studies and 8 case-control studies. The pooled analysis revealed that PA significantly reduced the risk of developing PD [relative risk (RR) = 0.77, 95% CI 0.70-0.85]. In addition, the dose-response analysis revealed both linear and nonlinear associations, with linear results indicating a 9% reduction in PD risk for every 10 MET-h/wk increase in PA. The study also demonstrated that the protective effect of PA against PD was significant for both sexes. Moreover, no statistically significant effects of PA on preventing PD were observed in individuals with a BMI > 26 (RR = 0.35, 95% CI 0.12-1.02) or in Asian populations (RR = 0.78, 95% CI 0.60-1.01); however, the trends suggest potential protective effects, warranting further investigation. Sensitivity analyses confirmed the robustness of these findings.
This meta-analysis produced substantial evidence to reaffirm the protective effect of high PA on PD across various population groups and the inverse dose-response relationship with PD risk, and to validate the protective effect of PA among different demographic groups.
虽然最近的荟萃分析表明，体力活动（PA）与帕金森病（PD）发病风险之间的关联受到性别差异的影响，但越来越多的研究表明这种关联在性别之间具有普遍性。本研究旨在重新评估人群中 PA 与 PD 风险之间的关联和剂量-反应关系。
本研究从成立到 2024 年 2 月 1 日，在 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库中进行了系统检索，没有语言限制。进行分层分析以探索 PA 与 PD 风险之间的关联，通过随机效应模型合并多变量调整后的效应估计，并验证两者之间的剂量-反应关系。
本研究纳入了 21 项观察性研究，包括 13 项队列研究和 8 项病例对照研究。汇总分析显示，PA 显著降低了 PD 的发病风险[相对风险（RR）=0.77，95%置信区间（CI）0.70-0.85]。此外，剂量-反应分析显示出线性和非线性关联，线性结果表明 PA 每增加 10 MET-h/wk，PD 风险降低 9%。研究还表明，PA 对预防 PD 的保护作用在两性中均显著。此外，对于 BMI>26（RR=0.35，95%CI 0.12-1.02）或亚洲人群（RR=0.78，95%CI 0.60-1.01），PA 对预防 PD 没有统计学显著影响，但趋势表明可能存在保护作用，需要进一步研究。敏感性分析证实了这些发现的稳健性。
本荟萃分析提供了大量证据，再次证实了高 PA 对不同人群 PD 的保护作用以及与 PD 风险的反向剂量-反应关系，并验证了 PA 在不同人群中的保护作用。
