Risk factors for dementia with Lewy bodies A case-control study
Risk factors for dementia with Lewy bodies A case-control study
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DOI：
10.1212/wnl.0b013e3182a2cbd1
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发表时间：
2013-08-27
期刊：
影响因子：
9.9
通讯作者：
Boeve, Bradley F.
中科院分区：
文献类型：
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作者：
Boot, Brendon P.;Orr, Carolyn F.;Boeve, Bradley F.
目的：探讨路易体痴呆的相关危险因素。方法：选取147例DLB患者，每例抽取2例性别和年龄相匹配的认知正常对照。我们还确定了一个由236名阿尔茨海默病（AD）患者组成的不匹配的对照组。我们在研究队列中评估了19个候选危险因素。结果：与对照组相比，DLB患者有焦虑史（优势比，95%可信区间）（7.4;3.5-16;p < 0.0001）、抑郁史（6.0;3.7-9.5;p < 0.0001）、中风史（2.8;1.3-6.3;p = 0.01）、帕金森病家族史（4.6;2.5-8.6;p < 0.0001）和携带APOE epsilon 4等位基因（2.2;1.5-3.3;p < 0.0001）的可能性更高，但患癌症（0.44;0.27-0.70;p = 0.0006）或使用咖啡因（0.29;0.14-0.57;p < 0.0001）的可能性更低。P < 0.0001)，酒精的趋势相似（0.65;0.42-1.0;P = 0.0501）。相比与广告主题,主题与下文年轻(72.5 vs 74.9年,p = 0.021),更可能是男性(优势比;95%置信区间)(5.3;3.3 - -8.5,p < 0.0001),有抑郁史(4.3;2.4 - -7.5;p < 0.0001),更教育(2.5;1.1 - -5.6;p = 0.031),有一个积极的家族史的PD (5.0; 2.4 -10; p < 0.0001),没有APOEε4等位基因(0.61;0.40 - -0.93;p = 0.02),并有卵巢切除术前45岁(-39 7.6;1.5;p = 0.015)。结论：DLB的危险因素是AD和PD的综合危险因素。吸烟和教育对AD和PD具有相反的风险作用，但不是DLB的危险因素；然而，抑郁和低咖啡因摄入都是AD和PD的危险因素，比两者都更强烈地增加了DLB的风险。
Objective: To determine the risk factors associated with dementia with Lewy bodies (DLB).Methods: We identified 147 subjects with DLB and sampled 2 sex- and age-matched cognitively normal control subjects for each case. We also identified an unmatched comparison group of 236 subjects with Alzheimer disease (AD). We evaluated 19 candidate risk factors in the study cohort.Results: Compared with controls, subjects with DLB were more likely to have a history of anxiety (odds ratio; 95% confidence interval) (7.4; 3.5-16; p < 0.0001), depression (6.0; 3.7-9.5; p < 0.0001), stroke (2.8; 1.3-6.3; p = 0.01), a family history of Parkinson disease (PD) (4.6; 2.5-8.6; p < 0.0001), and carry APOE epsilon 4 alleles (2.2; 1.5-3.3; p < 0.0001), but less likely to have had cancer (0.44; 0.27-0.70; p = 0.0006) or use caffeine (0.29; 0.14-0.57; p < 0.0001) with a similar trend for alcohol (0.65; 0.42-1.0; p = 0.0501). Compared with subjects with AD, subjects with DLB were younger (72.5 vs 74.9 years, p = 0.021) and more likely to be male (odds ratio; 95% confidence interval) (5.3; 3.3-8.5; p < 0.0001), have a history of depression (4.3; 2.4-7.5; p < 0.0001), be more educated (2.5; 1.1-5.6; p = 0.031), have a positive family history of PD (5.0; 2.4-10; p < 0.0001), have no APOE epsilon 4 alleles (0.61; 0.40-0.93; p = 0.02), and to have had an oophorectomy before age 45 years (7.6; 1.5-39; p = 0.015).Conclusion: DLB risk factors are an amalgam of those for AD and PD. Smoking and education, which have opposing risk effects on AD and PD, are not risk factors for DLB; however, depression and low caffeine intake, both risk factors for AD and PD, increase risk of DLB more strongly than in either.