Onset of Skin, Gut, and Genitourinary Prodromal Parkinson's Disease: A Study of 1.5 Million Veterans.
Onset of Skin, Gut, and Genitourinary Prodromal Parkinson's Disease: A Study of 1.5 Million Veterans.
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皮肤、肠道和泌尿生殖系统前驱帕金森病的发作：对 150 万退伍军人的研究。
DOI：
10.1002/mds.28636
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Quinn JF
中科院分区：
文献类型：
--
作者：
Scott GD;Lim MM;Drake MG;Woltjer R;Quinn JF
皮肤、泌尿生殖系统和胃肠道系统的前驱帕金森病为了解早期疾病发病机制和开发疾病修饰治疗提供了独特的窗口。然而，先前的研究受到时间信息不完整、样本量小和缺乏已知混杂因素调整的限制。考虑到这些器官的广泛应用，确定前驱期的时间和识别这些器官中的新疾病至关重要。我们的目的是在一个大型的，全国性的临床特征队列的150万参与者中测量胃肠道，泌尿生殖系统和皮肤疾病的发病时间。帕金森病患者（n = 303，693）使用美国退伍军人事务部医疗保健系统病历数据库中的诊断代码进行识别，并与匹配的对照组进行4：1比较。疾病的患病率和估计的发病时间进行了评估，为20年前的诊断。最早显著增加的前驱疾病是胃食管反流、性功能障碍和食管运动障碍，分别发生在诊断前17、16和15年。每种疾病的估计发病时间发生在首次测量增加前5.5 ± 3.4年。最早的估计发病时间是嗅觉/味觉，上消化道和性功能障碍，在诊断前20.9年，20.6年和20.1年。与睡眠障碍患者的既往研究相比，便秘和排尿功能障碍的发病时间明显延长了7年和9年。皮肤真菌病和前列腺肥大被确定为新的高发前驱疾病。胃肠道、泌尿生殖系统和皮肤疾病在帕金森病诊断前几十年就已显现，重申了它们作为开发早期诊断测试和了解发病机制的场所的潜力。
Prodromal Parkinson’s disease of skin, genitourinary, and gastrointestinal systems offers a unique window for understanding early disease pathogenesis and developing disease modifying treatments. However, prior studies are limited by incomplete timing information, small sample size, and lack of adjustment for known confounders. Verifying prodromal timing and identifying new disorders in these accessible organs is critically important given their broad use. We aimed to measure onset timing for gastrointestinal, genitourinary, and skin disorders in a large, nationwide clinically characterized cohort of 1.5 million participants. Patients with Parkinson’s disease (n = 303,693) were identified using diagnostic codes in the medical records database of the United States Veterans Affairs healthcare system and were compared 4:1 with matched controls. Disorder prevalence and estimated onset times were assessed for 20 years preceding diagnosis. The earliest significantly increased prodromal disorders were gastroesophageal reflux, sexual dysfunction, and esophageal dyskinesia at 17, 16, and 15 years before diagnosis. Estimated onset times for each disorder occurred 5.5 ± 3.4 years before the first measured increase. The earliest estimated onset times were smell/taste, upper gastrointestinal tract, and sexual dysfunction at 20.9, 20.6, and 20.1 years before diagnosis. Onset times for constipation and urinary dysfunction were notably longer by 7 and 9 years compared to prior studies in sleep disorder patients. Dermatophytosis and prostatic hypertrophy were identified as new high prevalence prodromal disorders. Gastrointestinal, genitourinary, and skin disorders manifest decades before diagnosis of Parkinson’s disease, reiterating their potential as sites for developing early diagnostic testing and understanding pathogenesis.
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影响因子：
8.6
作者：
Pont-Sunyer, Claustre;Hotter, Anna;Tolosa, Eduardo
通讯作者：
Tolosa, Eduardo
帕金森氏病的患病率在北美。
DOI：
10.1038/s41531-018-0058-0
发表时间：
2018
期刊：
NPJ Parkinson's disease
影响因子：
--
作者：
Marras C;Beck JC;Bower JH;Roberts E;Ritz B;Ross GW;Abbott RD;Savica R;Van Den Eeden SK;Willis AW;Tanner CM;Parkinson’s Foundation P4 Group
通讯作者：
Parkinson’s Foundation P4 Group
影响因子：
5
作者：
Davis, JW;Grandinetti, A;Morens, DM
通讯作者：
Morens, DM
影响因子：
8.6
作者：
Hall, Sara;Surova, Yulia;Ohrfelt, Annika;Blennow, Kaj;Zetterberg, Henrik;Hansson, Oskar
通讯作者：
Hansson, Oskar
影响因子：
7.1
作者：
Clairembault T;Leclair-Visonneau L;Coron E;Bourreille A;Le Dily S;Vavasseur F;Heymann MF;Neunlist M;Derkinderen P
通讯作者：
Derkinderen P