Clinical associations between gout and multiple sclerosis, Parkinson's disease and motor neuron disease: record-linkage studies.
Clinical associations between gout and multiple sclerosis, Parkinson's disease and motor neuron disease: record-linkage studies.
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痛风与多发性硬化症，帕金森氏病和运动神经元疾病之间的临床关联：记录链接研究。
DOI：
10.1186/s12883-015-0273-9
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发表时间：
2015-02-28
期刊：
影响因子：
2.6
通讯作者：
Goldacre MJ
中科院分区：
文献类型：
--
作者：
Pakpoor J;Seminog OO;Ramagopalan SV;Goldacre MJ
尿酸对神经元有抗氧化作用。然而，异常高的尿酸水平与痛风有关。先前的研究表明，高水平的尿酸(以及痛风的存在)可能会对患某些神经系统疾病的风险起到保护作用。我们的目标是在英格兰的一个大型医院入院数据库中调查这一假设。我们分析了英国(1999-2012年)住院和死亡登记相关统计记录的数据库。建立了痛风患者队列，并对多发性硬化症(MS)、帕金森病(PD)或运动神经元病(MND)的发生进行了跟踪调查。然后，相反地，建立数据库中所有患有MS、PD或MND的人的队列，并对随后的痛风进行跟踪。确定了比率比(RR)，将这些队列与参考队列中的人进行比较。在痛风队列中，我们观察到随后的MS、PD和MND的总体风险略有上升(分别为RR = 1.27(95%可信区间1.03-1.55)、1.11(1.05-1.17)和1.28(1.11-1.48))，这主要是由于在痛风住院后的早期观察到的风险增加。神经疾病风险的增加在5年后并未保持。在MS或PD患者的队列中，随后痛风入院的风险显著降低(RR = 分别为0.79(0.69-0.89)和0.83(0.79-0.87))。随着时间的推移，这种反向关联一直保持着。痛风后发生MND的风险也较低，痛风在首次入院五年后才出现(5年以上的RR为0.35(0.15-0.68))。本研究调查了以痛风为代表的高血尿酸在MS、PD或MND病因学中的保护作用的流行病学证据。我们的观察结果并不支持这一假设。然而，当顺序颠倒时，我们对MS、PD和MND患者进行了多年的回顾性跟踪，我们发现痛风在统计学上存在显著缺陷。提示这些神经退行性疾病的某些方面与尿酸代谢有关。
Uric acid has antioxidant effects on neurons. Abnormally high levels of uric acid are, however, associated with gout. Previous studies have suggested that high levels of uric acid (and the presence of gout) may exert a protective effect against the risk of developing some neurological diseases. We aimed to investigate this hypothesis in a large database of hospital admissions in England. We analysed a database of linked statistical records of hospital admissions and death registrations in England (1999–2012). A cohort of people with gout was constructed and followed for development of multiple sclerosis (MS), Parkinson’s disease (PD) or motor neuron disease (MND). Then, conversely, cohorts of all people in the database with MS, PD or MND were constructed and followed for subsequent gout. Rate ratios (RRs) were determined, comparing these cohorts with people in a reference cohort. In the gout cohort, we observed a modest elevation of the overall risk of subsequent MS, PD and MND (respectively, RR = 1.27 (95% confidence interval 1.03-1.55), 1.11 (1.05-1.17) and 1.28 (1.11-1.48) which was largely attributable to an increased risk observed in the early years after hospitalisation for gout. The increased risk of neurological disease did not remain after 5 years. In the cohorts of people with MS or PD, there was a significantly reduced risk of subsequent gout admission (RR = 0.79 (0.69-0.89) and 0.83 (0.79-0.87), respectively). This inverse association was sustained over time. There was also a reduced risk of MND following gout which only emerged more than five years following initial gout admission (RR at 5+ years 0.35 (0.15-0.68)). This study investigated the epidemiological evidence for a protective role of high serum concentration of uric acid, for which we used gout as a proxy, in the aetiology of MS, PD or MND. Our observations do not support this hypothesis. However, when the order was reversed, and we retrospectively followed up patients with MS, PD and MND for a number of years, we found a statistically significant deficit of gout. This suggests that there is relationship between some aspects of these neurodegenerative diseases and metabolism of uric acid.
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影响因子：
3.9
作者：
Yeum, KJ;Russell, RM;Aldini, G
通讯作者：
Aldini, G
影响因子：
11.2
作者：
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Alam, ZI;Jenner, A;Halliwell, B
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作者：
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作者：
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