Differences in the Presentation and Progression of Parkinson's Disease by Sex.
Differences in the Presentation and Progression of Parkinson's Disease by Sex.
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DOI：
10.1002/mds.28312
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Nalls MA
中科院分区：
文献类型：
--
作者：
Iwaki H;Blauwendraat C;Leonard HL;Makarious MB;Kim JJ;Liu G;Maple-Grødem J;Corvol JC;Pihlstrøm L;van Nimwegen M;Smolensky L;Amondikar N;Hutten SJ;Frasier M;Nguyen KH;Rick J;Eberly S;Faghri F;Auinger P;Scott KM;Wijeyekoon R;Van Deerlin VM;Hernandez DG;Gibbs RJ;Day-Williams AG;Brice A;Alves G;Noyce AJ;Tysnes OB;Evans JR;Breen DP;Estrada K;Wegel CE;Danjou F;Simon DK;Andreassen OA;Ravina B;Toft M;Heutink P;Bloem BR;Weintraub D;Barker RA;Williams-Gray CH;van de Warrenburg BP;Van Hilten JJ;Scherzer CR;Singleton AB;Nalls MA
先前的研究报道了与性有关的帕金森病（PD）的各种症状。有些是相互矛盾的或仅在一项研究中得到证实。我们在大规模数据中横向和纵向研究了性别与 PD 表型的关联。我们使用纵向、基于临床的患者队列测试了 40 种临床表型，该队列由 5946 名患者组成，中位随访时间为 3.1 年。对于连续结果，我们使用基线线性回归来测试表现中的性别相关差异，并使用线性混合效应模型来测试进展中的性别相关差异。对于二项式结果，我们使用基线逻辑回归模型和 Cox 回归模型进行生存分析。我们根据年龄、病程和药物使用情况进行了调整。在二次分析中，对来自仅在线自我评估 PD 队列的 17719 名 PD 患者和 7588 名非 PD 参与者的数据进行了横断面评估，以确定主要分析中确定的性别相关差异是否与 PD 一致且独特。与男性患者相比，女性PD患者在随访早期出现运动障碍的风险较高，日常生活困难的进展较慢，发生认知障碍的风险较低。基于临床的纵向队列的研究结果与仅在线队列的结果基本一致。我们观察到性别对 PD 异质性的影响。这些结果强调了未来研究的必要性，以确定个性化临床管理的潜在机制和重要性。
Previous studies reported various symptoms of Parkinson’s disease (PD) associated with sex. Some were conflicting or confirmed in only one study. We examined sex associations to PD phenotypes cross-sectionally and longitudinally in large-scale data. We tested 40 clinical phenotypes, using longitudinal, clinic-based patient cohorts, consisting of 5946 patients, with a median follow-up of 3.1 years. For continuous outcomes, we used linear regressions at baseline to test sex-associated differences in presentation, and linear mixed-effects models to test sex-associated differences in progression. For binomial outcomes, we used logistic regression models at baseline and Cox regression models for survival analyses. We adjusted for age, disease duration, and medication use. In the secondary analyses, data from 17 719 PD patients and 7588 non-PD participants from an online-only, self-assessment PD cohort were cross-sectionally evaluated to determine whether the sex-associated differences identified in the primary analyses were consistent and unique to PD. Female PD patients had a higher risk of developing dyskinesia early during the follow-up period, with a slower progression in activities of daily living difficulties, and a lower risk of developing cognitive impairments compared with male patients. The findings in the longitudinal, clinic-based cohorts were mostly consistent with the results of the online-only cohort. We observed sex-associated contributions to PD heterogeneity. These results highlight the necessity of future research to determine the underlying mechanisms and importance of personalized clinical management.
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影响因子：
2.9
作者：
Pendlebury, S. T.;Markwick, A.;Rothwell, P. M.
通讯作者：
Rothwell, P. M.
DOI：
10.3233/jad-170203
发表时间：
2017
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
--
作者：
Borland E;Nägga K;Nilsson PM;Minthon L;Nilsson ED;Palmqvist S
通讯作者：
Palmqvist S
影响因子：
8.6
作者：
Accolla, Ettore;Caputo, Elena;Priori, Alberto
通讯作者：
Priori, Alberto
影响因子：
6
作者：
Martinez-Martin, Pablo;Pecurariu, Cristian Falup;Chaudhuri, Kallol Ray
通讯作者：
Chaudhuri, Kallol Ray
影响因子：
9.8
作者：
Smolensky, Luba;Amondikar, Ninad;Tanner, Caroline
通讯作者：
Tanner, Caroline