Tzourio C, Rocca W A, Breteler M M, Baldereschi M, Dartigues J F, Lopez-Pousa S, Manubens-Bertran J M, Alpérovitch A
INSERM U 360 Recherches Epidémiologiques en Neurologie et Psychopathologie, Hôpital de la Salpêtrière, Paris, France.
Neurology. 1997 Nov;49(5):1267-72. doi: 10.1212/wnl.49.5.1267.
We studied the association between smoking and Parkinson's disease (PD) through a case-control study. Several studies have shown an inverse association between smoking and PD. This association has been interpreted as spurious by some investigators, and as real and causal by others. Several other studies did not confirm the inverse association. We included 193 prevalent cases of PD ascertained in five European prevalence surveys that followed a two-phase design of screening and clinical examination. Each case was matched by center, age (+/- 2 years), and gender to three control subjects drawn from the same populations (N = 579). Information on smoking was obtained through direct or proxy interview. Overall, there was no association between ever smoking and PD (odds ratio = 1.1; p = 0.6). Analyses stratified by age showed that ever smoking was associated with a decreased risk of PD in the younger individuals (odds ratio = 0.4; p = 0.03) and with a significant trend of increasing risk with advancing age (p = 0.003). The risk of PD in relation to smoking is strongly modified by age; smoking may be protective in the younger cases but not in the older cases. This finding may explain the conflicting results from previous studies.
我们通过一项病例对照研究，探讨了吸烟与帕金森病（PD）之间的关联。多项研究表明，吸烟与PD之间存在负相关。一些研究者认为这种关联是虚假的，而另一些人则认为是真实且有因果关系的。其他一些研究并未证实这种负相关。我们纳入了在五项欧洲患病率调查中确定的193例PD现患病例，这些调查采用了筛查和临床检查的两阶段设计。每个病例按照中心、年龄（±2岁）和性别，与从相同人群中抽取的三名对照受试者进行匹配（N = 579）。通过直接访谈或代理访谈获取吸烟信息。总体而言，曾经吸烟与PD之间没有关联（比值比 = 1.1；p = 0.6）。按年龄分层分析显示，曾经吸烟与较年轻个体患PD的风险降低相关（比值比 = 0.4；p = 0.03），并且随着年龄增长，风险有显著增加的趋势（p = 0.003）。吸烟与PD的风险因年龄而有很大差异；吸烟在较年轻病例中可能具有保护作用，但在老年病例中则不然。这一发现可能解释了先前研究中相互矛盾的结果。
