Female reproductive factors, menopausal hormone use, and Parkinson's disease.
Female reproductive factors, menopausal hormone use, and Parkinson's disease.
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DOI：
10.1002/mds.25771
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发表时间：
2014-06
影响因子：
8.6
通讯作者：
Chen, Honglei
中科院分区：
文献类型：
--
作者：
Liu, Rui;Baird, Donna;Park, Yikyung;Freedman, Neal D.;Huang, Xuemei;Hollenbeck, Albert;Blair, Aaron;Chen, Honglei
探讨生殖因素和外源性激素使用与绝经后妇女帕金森病（PD）风险的关系。该研究纳入了美国国立卫生研究院-美国退休人员协会饮食与健康研究项目中119,166名年龄在50-71岁之间的绝经后妇女，她们在1995-1996年完成了一份基线问卷调查，并在2004-2006年完成了一项后续调查。1995年至2006年间，共有410例自我报告的PD诊断被确诊。多变量优势比（OR）和95%置信区间（CI）来自逻辑回归模型。PD风险与女性生殖因素（包括初潮年龄、首次活产年龄、胎次和绝经年龄）无显著相关性。例如，与50-54岁自然绝经妇女相比，45岁以下自然绝经妇女的or为1.18 (95% CI 0.78-1.79)， 45 - 49岁自然绝经妇女的or为1.19(0.88-1.61)，55岁及以上自然绝经妇女的or为1.33（0.91-1.93）。我们发现口服避孕药使用≥10年（与从未使用相比）与较低的PD风险相关（OR=0.59; 0.38-0.92），但较短的使用没有关联。使用绝经期激素治疗显示不一致的结果。与基线时未使用激素的患者相比，目前使用激素<5年的患者患PD的风险更高（OR=1.52; 1.11-2.08）。然而，在过去的激素使用者或目前≥5年的激素使用者中没有观察到相关性。总的来说，这项大型前瞻性研究很少支持女性生殖因素与PD风险之间的关联。我们对长期口服避孕药使用和当前激素治疗的研究结果值得进一步研究。
To examine the associations of reproductive factors and exogenous hormone use with risk of Parkinson’s disease (PD) among postmenopausal women. The study comprised 119,166 postmenopausal women ages 50–71 years in the NIH-AARP Diet and Health Study, who completed a baseline questionnaire in 1995–1996 and a follow-up survey in 2004–2006. A total of 410 self-reported PD diagnoses were identified between 1995 and 2006. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were derived from logistic regression models. PD risk was not significantly associated with female reproductive factors including age at menarche, age at first live birth, parity, and age at menopause. For example, compared with women with natural menopause at ages 50–54 years, the ORs were 1.18, (95% CI 0.78–1.79) for women with natural menopause at ages <45, 1.19 (0.88–1.61) for ages 45–49, and 1.33 (0.91–1.93) for ages 55 or later. We found that oral contraceptive use for ≥10 years (vs. never use) was associated with lower PD risk (OR=0.59; 0.38–0.92) but shorter use showed no association. Use of menopausal hormone therapy showed inconsistent results. Compared with non-hormone users at baseline, current hormone users of <5 years showed a higher risk of PD (OR=1.52; 1.11–2.08). However, no associations were observed for past hormone users or current users of ≥5 years. Overall, this large prospective study provides little support for an association between female reproductive factors and PD risk. Our findings on long-term oral contraceptive use and current hormone therapy warrant further investigations.
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