INVERSE ASSOCIATION OF ANTIINFLAMMATORY TREATMENTS AND ALZHEIMERS-DISEASE - INITIAL RESULTS OF A COTWIN CONTROL STUDY
INVERSE ASSOCIATION OF ANTIINFLAMMATORY TREATMENTS AND ALZHEIMERS-DISEASE - INITIAL RESULTS OF A COTWIN CONTROL STUDY
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DOI：
10.1212/wnl.44.2.227
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发表时间：
1994-02-01
期刊：
影响因子：
9.9
通讯作者：
ANTHONY, JC
中科院分区：
文献类型：
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作者：
BREITNER, JCS;GAU, BA;ANTHONY, JC
我们在50对老年双胞胎中进行了一项双胞胎对照研究，这些老年双胞胎的阿尔茨海默病（AD）发作间隔3年或更长时间。23对男性（46%）从（美国）美国国家科学院-国家研究理事会登记处（NAS-NRC登记处）的二战老兵双胞胎;其他人（主要是女性）对广告有反应或从AD诊所转介。26对（52%）为单合子。AD的发生与既往使用皮质类固醇或ACTH呈负相关（比值比[OR]，0.25; 95%置信区间[CI]，0.06 - 0.95; p = 0.04）。在关节炎史或既往每日使用非甾体类抗炎药（NSAID）或阿司匹林不一致的配对中，存在相似但较弱的趋势。当我们事后将类固醇/ACTH或NSAID的使用合并为抗炎药（AI）的单一变量时，相关性最强（OR，0.24; CI，0.07至0.74; p = 0.01）。这种负相关在女性（志愿者）双胞胎中很强，但在NAS-NRC登记处的年轻男性中不存在。AI通常用于关节炎或相关疾病，但在对关节炎变量进行统计学控制后，相似的结果是明显的（OR，0.08; CI，0.01至0.69; p = 0.02）。AI已被提议作为延缓AD症状进展的一种手段，这些数据表明，AI也可能预防或延迟AD症状的首次发作。由于病例对照方法的局限性，我们的研究结果需要与旨在控制偏倚和混杂的假设驱动研究进行确证。
We conducted a co-twin control study among 50 elderly twin pairs with onsets of Alzheimer's disease (AD) separated by 3 or more years. Twenty-three male pairs (46%) were screened from the (U.S.) National Academy of Sciences-National Research Council Registry (NAS-NRC Registry) of World War II veteran twins; others (mostly women) had responded to advertisements or were referred from AD clinics. Twenty-six pairs (52%) were monozygous. The onset of AD was inversely associated with prior use of corticosteroids or ACTH (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.06 to 0.95; p = 0.04). Similar but weaker trends were present among pairs discordant for history of arthritis or for prior daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. The association was strongest when we combined use of steroids/ACTH or NSAIDs post hoc into a single variable of anti-inflammatory drugs (AIs) (OR, 0.24; CI, 0.07 to 0.74; p = 0.01). The inverse relation was strong in female (volunteer) twin pairs but was not present in the younger men from the NAS-NRC Registry. AIs had typically been taken for arthritis or related conditions, but a similar result was apparent after controlling statistically for the arthritis variable (OR, 0.08; CI, 0.01 to 0.69; p = 0.02). AIs have been proposed as a means of retarding the progression of AD symptoms, and these data suggest that AIs may also prevent or delay the initial onset of AD symptoms. Because of limitations in the case-control method, our results require corroboration with hypothesis-driven research designed to control bias and confounding.