Smoking and Parkinson's disease - A dose-response relationship
Smoking and Parkinson's disease - A dose-response relationship
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DOI：
10.1212/wnl.52.1.115
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发表时间：
1999-01-01
期刊：
影响因子：
9.9
通讯作者：
Peterson, EL
中科院分区：
文献类型：
--
作者：
Gorell, JM;Rybicki, BA;Peterson, EL
目的：探讨吸烟与帕金森病之间是否存在反剂量-反应关系。研究方法：在亨利福特健康系统中，对144例PD患者和464例对照受试者的吸烟和饮酒情况进行了分析，这些患者的性别、种族和年龄（+/-5岁）频率匹配。结果如下：以从不吸烟者作为参考类别，目前轻度吸烟者（>0至30包-年）与PD患者之间存在负相关（比值比[OR]，0.59; 95%CI，0.23至1.53），PD与目前重度吸烟者之间存在更强的负相关（>30包-年; OR，0.08; 95%CI，0.01至0.62）。当根据戒烟后的时间间隔对吸烟>30包年的吸烟者进行分层时，>20年前戒烟的吸烟者与PD呈负相关（OR，0.86; 95%CI，0.42至1.75），与1至20年前戒烟的吸烟者呈更大的负相关（OR，0.37; 95%CI，0.19至0.72）。饮酒与帕金森病之间没有独立的、显著的相关性，但大量饮酒（>10饮酒年）在减少但不能消除吸烟与帕金森病之间的负相关性方面比轻中度饮酒有更大的作用。结论：PD和吸烟及其戒烟之间的反向剂量-反应关系不太可能是由于偏倚或混淆，如所讨论的，提供了间接证据表明吸烟具有生物保护作用。
Objective: To determine whether an inverse dose-response relationship exists between cigarette smoking and PD among ever-smokers and ex-smokers. Methods: Smoking and alcohol consumption were analyzed in 144 PD patients and 464 control subjects, who were frequency matched for sex, race, and age (+/-5 years), in a population-based ease-control study of men and women greater than or equal to 50 years old in the Henry Ford Health System. Results: With never-smokers as the reference category, there was an inverse association between current light smokers (>0 to 30 pack-years) and PD patients (odds ratio [OR], 0.59; 95% CI, 0.23 to 1.53), and a stronger inverse association of PD with current heavy smokers (>30 pack-years; OR, 0.08; 95% CI, 0.01 to 0.62). When former >30-pack-year smokers were stratified by the interval since quitting, there was an inverse association between those who stopped >20 years ago and PD (OR, 0.86; 95% CI, 0.42 to 1.75), and a greater inverse relationship with those who stopped 1 to 20 years ago (OR, 0.37; 95% CI, 0.19 to 0.72). Alcohol consumption had no independent, significant association with PD, but heavy drinking (>10 drink-years) had a greater effect than light-moderate drinking in reducing but not eliminating the inverse association between smoking and PD. Conclusions: The inverse dose-response relationship between PD and smoking and its cessation is unlikely to be due to bias or confounding, as discussed, providing indirect evidence that smoking is biologically protective.