Park You Hyun, Kim Yong Wook, Kang Dae Ryong, Yoon Seo Yeon
Department of Biostatistics, Graduate School of Yonsei University, Seoul, Republic of Korea.
National Health Big Data Clinical Research Institute, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of.
J Neural Transm (Vienna). 2025 Jul 7. doi: 10.1007/s00702-025-02976-2.
Previous studies on the association between alcohol consumption and risk of Parkinson's disease (PD) have produced controversial results. However, the relationship between alcohol consumption and mortality in PD has scarcely been investigated. Among the nationwide population data from Korea National Health Insurance Service, newly diagnosed PD (ICD-10 code: G20 and a rare intractable disease registration code: V124), between 2009 and 2017, were selected. Alcohol consumption habit was obtained from a self-reported questionnaire on the National Health Screening Program. 32,419 individuals with PD were followed-up longitudinally until December 31, 2017, and all-cause mortality was evaluated. During the follow-up period (mean 4.37 ± 2.67 years), 9,049 deaths occurred. When nondrinkers are used as a reference group, there were significant associations between alcohol consumption and all-cause mortality in mild (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.71-0.84) and moderate drinkers (HR 0.69, 95% CI 0.58-0.82), but not in heavy drinkers (HR 0.84, 95% CI 0.69-1.02). In the sensitivity analysis using never drinkers as the reference group, the results also showed an overall 20% reduced mortality risk among drinkers with PD. Regarding changes in alcohol consumption behavior before and after diagnosis, the mortality rate was higher in former drinkers (HR 1.20, 95% CI 1.02-1.41) and lower in constant drinkers (HR 0.74, 95% CI 0.65-0.83) than in never drinkers. Alcohol consumption appears to be associated with reduced all-cause mortality in PD, suggesting potential neuroprotective effects on disease progression. Although drinking does not appear to be detrimental to all-cause mortality in individuals with PD, alcohol consumption in PD requires attention considering individual motor and non-motor symptoms. Future studies in other ethnic groups are warranted to validate the association between alcohol consumption and disease progression, including mortality, in PD.
先前关于饮酒与帕金森病（PD）风险之间关联的研究结果存在争议。然而，饮酒与PD患者死亡率之间的关系却鲜有研究。在韩国国民健康保险服务中心的全国人口数据中，选取了2009年至2017年间新诊断为PD（国际疾病分类第十版代码：G20以及罕见难治性疾病登记代码：V124）的患者。饮酒习惯通过国民健康筛查项目中的一份自我报告问卷获得。对32419名PD患者进行纵向随访直至2017年12月31日，并评估全因死亡率。在随访期间（平均4.37±2.67年），有9049人死亡。以不饮酒者作为参照组，轻度饮酒者（风险比[HR]0.78，95%置信区间[CI]0.71 - 0.84）和中度饮酒者（HR 0.69，95% CI 0.58 - 0.82）的饮酒量与全因死亡率之间存在显著关联，但重度饮酒者（HR 0.84，95% CI 0.69 - 1.02）则不然。在以从不饮酒者作为参照组的敏感性分析中，结果也显示PD患者中饮酒者的总体死亡风险降低了20%。关于诊断前后饮酒行为的变化，与从不饮酒者相比，既往饮酒者的死亡率更高（HR 1.20，95% CI 1.02 - 1.41），持续饮酒者的死亡率更低（HR 0.74，95% CI 0.65 - 0.83）。饮酒似乎与PD患者全因死亡率降低有关，提示对疾病进展可能具有神经保护作用。虽然饮酒似乎对PD患者的全因死亡率并无不利影响，但考虑到个体的运动和非运动症状，PD患者的饮酒情况仍需关注。有必要在其他种族群体中开展进一步研究，以验证饮酒与PD疾病进展（包括死亡率）之间的关联。
