Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries.
Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries.
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DOI：
10.1016/j.parkreldis.2018.02.008
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发表时间：
2018-05
影响因子：
4.1
通讯作者：
Racette BA
中科院分区：
文献类型：
--
作者：
Camacho-Soto A;Gross A;Searles Nielsen S;Dey N;Racette BA
胃肠道（GI）功能障碍先于帕金森病（PD）的运动症状数年。PD患者存在肠道α-突触核蛋白的异常聚集，炎症反应可能促进了α-突触核蛋白的聚集。肠道α-突触核蛋白聚集体与中枢神经系统神经病理学之间的关系尚不清楚。最近，我们观察到炎症性肠病（IBD）和PD之间可能存在负相关，作为PD预测模型的一部分。因此，本研究的目的是检查PD风险与IBD以及IBD相关疾病和治疗之间的关系。采用病例对照设计，我们使用2004-2009年的综合医疗保险数据（包括详细的索赔数据）确定了89，790例新诊断的PD病例和118，095例基于人群的对照，年龄> 65岁。我们使用国际疾病分类第9版（ICD-9）诊断代码对IBD进行分类。我们使用逻辑回归计算比值比（OR）和95%置信区间（CI），以评估PD和IBD之间的关联。协变量包括年龄、性别、人种/种族、吸烟、Elixhauser合并症和医疗保健使用。PD与总体IBD（OR = 0.85，95% CI 0.80-0.91）以及克罗恩病（OR = 0.83，95% CI 0.74-0.93）和溃疡性结肠炎（OR = 0.88，95% CI 0.82- 0.96）呈负相关。在IBD ICD-9编码≥ 2个的受益人中，IBD ICD-9编码数量（作为IBD严重程度的潜在指标）与PD之间存在反向剂量反应相关性（趋势p = 0.006）。IBD与发生PD的风险较低相关。
Gastrointestinal (GI) dysfunction precedes the motor symptoms of Parkinson’s disease (PD) by several years. PD patients have abnormal aggregation of intestinal α-synuclein, the accumulation of which may be promoted by inflammation. The relationship between intestinal α-synuclein aggregates and central nervous system neuropathology is unknown. Recently, we observed a possible inverse association between inflammatory bowel disease (IBD) and PD as part of a predictive model of PD. Therefore, the objective of this study was to examine the relationship between PD risk and IBD and IBD-associated conditions and treatment. Using a case-control design, we identified 89,790 newly diagnosed PD cases and 118,095 population-based controls > 65 years of age using comprehensive Medicare data from 2004–2009 including detailed claims data. We classified IBD using International Classification of Diseases version 9 (ICD-9) diagnosis codes. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between PD and IBD. Covariates included age, sex, race/ethnicity, smoking, Elixhauser comorbidities, and health care use. PD was inversely associated with IBD overall (OR = 0.85, 95% CI 0.80–0.91) and with both Crohn’s disease (OR = 0.83, 95% CI 0.74–0.93) and ulcerative colitis (OR = 0.88, 95% CI 0.82– 0.96). Among beneficiaries with ≥ 2 ICD-9 codes for IBD, there was an inverse dose-response association between number of IBD ICD-9 codes, as a potential proxy for IBD severity, and PD (p-for-trend = 0.006). IBD is associated with a lower risk of developing PD.
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影响因子：
48
作者：
Schrag, Anette;Horsfall, Laura;Petersen, Irene
通讯作者：
Petersen, Irene
影响因子：
11.2
作者：
Hernán, MA;Takkouche, B;Gestal-Otero, JJ
通讯作者：
Gestal-Otero, JJ
影响因子：
9.9
作者：
Nielsen, Susan Searles;Warden, Mark N.;Racette, Brad A.
通讯作者：
Racette, Brad A.
影响因子：
5.3
作者：
Miklossy, J;Doudet, DD;McGeer, PL
通讯作者：
McGeer, PL
影响因子：
4.7
作者：
Villaran, Ruth F.;Espinosa-Oliva, Ana M.;Machado, Alberto
通讯作者：
Machado, Alberto