Caffeine, postmenopausal estrogen, and risk of Parkinson's disease
Caffeine, postmenopausal estrogen, and risk of Parkinson's disease
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DOI：
10.1212/01.wnl.0000046523.05125.87
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发表时间：
2003-03-11
期刊：
影响因子：
9.9
通讯作者：
Speizer, FE
中科院分区：
文献类型：
--
作者：
Ascherio, A;Chen, H;Speizer, FE
背景：经常饮用含咖啡因饮料的男性比不饮酒的男性患帕金森病的风险更低，但这种关系在女性中尚未发现。由于这种性别差异可能是由于荷尔蒙的影响，作者根据绝经后激素的使用和咖啡因的摄入量对护士健康研究的参与者进行了前瞻性的帕金森病风险检查。方法：研究人群包括77,713名基线时无帕金森病、中风或癌症的妇女，她们在基线时是绝经后的，或者在研究结束前达到绝经的。在18年的随访中，作者记录了154例帕金森病。结果：总的来说，使用激素的妇女和从不使用激素的妇女患帕金森病的风险相似(相对危险度1.02，95%可信区间0.69至1.52)。然而，激素的使用与低咖啡因摄入量的女性患帕金森病的风险降低(相对危险度0.39，95%可信区间0.13至1.17)和高咖啡因摄入量的女性患帕金森病的风险增加(相对危险度2.44，95%可信区间0.75至7.86；交互作用=0.01)相关。在激素使用者中，每天喝6杯或更多咖啡的女性患帕金森病的风险是从不喝咖啡的女性的四倍(RR3.92，95%可信区间1.49至10.34；p=0.006)。结论：这些结果表明，咖啡因降低了不使用绝经后激素的女性患帕金森病的风险，但增加了使用激素的女性的风险。在女性身上进行的咖啡因或雌激素的临床试验应该避免联合使用这些药物。
Background: Men who regularly consume caffeinated drinks have a lower risk of PD than do nondrinkers, but this relation has not been found in women. Because this sex difference could be due to hormonal effects, the authors examined prospectively the risk of PD according to use of postmenopausal hormones and caffeine intake among participants in the Nurses' Health Study. Methods: The study population comprised 77,713 women free of PD, stroke, or cancer at baseline, who were postmenopausal at baseline or reached menopause before the end of the study. During 18 years of follow-up the authors documented 154 cases of PD. Results: Overall, the risk of PD was similar in women using hormones and women who never used hormones (relative risk 1.02, 95% CI 0.69 to 1.52). Use of hormones, however, was associated with a reduced risk of PD among women with low caffeine consumption (RR 0.39, 95% CI 0.13 to 1.17), and with increased risk among women with high caffeine consumption (RR 2.44, 95% CI 0.75 to 7.86; p for interaction = 0.01). Among hormone users, women consuming six or more cups of coffee per day had a fourfold higher risk of PD (RR 3.92, 95% CI 1.49 to 10.34; p = 0.006) than did women who never drink coffee. Conclusions: These results suggest that caffeine reduces the risk of PD among women who do not use postmenopausal hormones, but increases risk among hormone users. Clinical trials of caffeine or estrogens in women should avoid the combined use of these agents.