Methamphetamine/amphetamine abuse and risk of Parkinson's disease in Utah: a population-based assessment.
Methamphetamine/amphetamine abuse and risk of Parkinson's disease in Utah: a population-based assessment.
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DOI：
10.1016/j.drugalcdep.2014.10.027
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发表时间：
2015-01-01
影响因子：
4.2
通讯作者：
Hanson, Glen R.
中科院分区：
文献类型：
--
作者：
Curtin, Karen;Fleckenstein, Annette E.;Robison, Reid J.;Crookston, Michael J.;Smith, Ken R.;Hanson, Glen R.
尽管甲基苯丙胺和其他苯丙胺类兴奋剂（甲基苯丙胺/苯丙胺类兴奋剂）被广泛使用，但对甲基苯丙胺/苯丙胺类兴奋剂滥用和依赖的长期医疗后果知之甚少。临床前神经毒性研究结果引起了公众对这些兴奋剂可能损害多巴胺神经元的关注，导致多巴胺相关疾病，如帕金森病（PD）。回顾性设计用于检查与犹他州人口数据库相关的全州医疗记录（1996年至2011年）。2011年12月31日30岁或以上的个体被分配到冰毒/AMPH队列（ICD-9-CM 304.4, 305.7, 969.7, E854.2， N=4,935），可卡因队列（ICD-9-CM 304.2, 305.6, 968.5, E855.2， N=1,867）或未暴露于药物或酒精的人群队列作为对照选择。使用竞争风险，比例风险模型来确定冰毒/AMPH或可卡因队列与单独性别和年龄匹配的对照组（对照与病例比为5:1，N=34,010）相比，PD （ICD-9-CM 332.0）或PD/帕金森病/特发性震颤（PD/PT; ICD-9-CM 332.0, 332.1, 333.0, 333.1）的风险是否增加。在甲基安非他明/AMPH使用者中，我们观察到与基于人群的对照组相比，PD和PD/PT的风险增加（HRPD=2.8, 95%CI 1.6-4.8， P<10−3;HRPD/PT=3.1, 95%CI 1.9-4.9， P<10−4）。相反，与对照组相比，可卡因使用者没有表现出PD风险升高。我们观察到甲基安非他明/AMPH服用者患PD的风险比对照组增加了近3倍，这证实了先前的观察结果，并支持服用者患PD的风险可能高于先前的估计。女性和男性使用者在PD易感性方面可能存在差异，这一建议值得进一步研究。
Despite widespread use of methamphetamine and other amphetamine-type stimulants (METH/AMPH), little is known about the long-term medical consequences of METH/AMPH abuse and dependence. Preclinical neurotoxicity findings raise public health concerns that these stimulants may damage dopamine neurons, resulting in dopamine-related disorders such as Parkinson’s disease (PD). A retrospective design was used to examine statewide medical records (1996 through 2011) linked to the Utah Population Database. Individuals 30y or older on December 31, 2011 were assigned to a METH/AMPH cohort (ICD-9-CM 304.4, 305.7, 969.7, E854.2; N=4,935), a cocaine cohort (ICD-9-CM 304.2, 305.6, 968.5, E855.2; N=1,867) or a population cohort unexposed to drugs or alcohol for control selection. A competing-risks, proportional hazards model was used to determine whether the METH/AMPH or cocaine cohorts were at increased risk of developing PD (ICD-9-CM 332.0) or PD/parkinsonism/essential tremor (PD/PT; ICD-9-CM 332.0, 332.1, 333.0, 333.1) compared to individually sex- and age-matched controls (5:1 control to case ratio; N=34,010). In METH/AMPH users, we observed an increased risk of PD and PD/PT (HRPD=2.8, 95%CI 1.6–4.8, P<10−3; HRPD/PT=3.1, 95%CI 1.9–4.9, P<10−4) compared to population-based controls. Conversely, cocaine users exhibited no elevated risk of PD compared to controls. We observed a near 3-fold increased risk of PD in METH/AMPH users vs. controls which confirms prior observations and supports that PD risk in users may be higher than previous estimates. A suggestion that female and male users may differ in PD susceptibility warrants further study.
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影响因子：
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作者：
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