Long-term Risk of Parkinson Disease Following Influenza and Other Infections
Long-term Risk of Parkinson Disease Following Influenza and Other Infections
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DOI：
10.1001/jamaneurol.2021.3895
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发表时间：
2021-10-25
期刊：
影响因子：
29
通讯作者：
Henderson, Victor W.
中科院分区：
文献类型：
--
作者：
Cocoros, Noelle M.;Svensson, Elisabeth;Henderson, Victor W.
重要性流感已与发展帕金森病的风险，但该协会是有争议的。目的检查是否以前的流感和其他感染与帕金森病超过10年后infection.Design，设置，和参与者这个病例对照研究使用的数据从1977年到2016年从丹麦国家患者登记处。所有帕金森病患者（不包括药物诱导的帕金森综合征患者）均纳入研究，并在性别、年龄和帕金森病诊断日期方面与5个人群对照组相匹配。分析了2019年12月至2021年9月的数据。EXPOSURES感染是在1977年至2016年期间确定的，并根据从感染到帕金森病诊断的时间进行分类。为了增加流感诊断的特异性，将流感暴露限制在流感活动高峰期的月份。主要结果和指标帕金森病诊断在2000年1月1日至2016年12月31日期间确定。通过条件Logistic回归计算总体和感染与帕金森病之间的时间分层的粗比值比（OR）和调整后的比值比（OR）和95% CI结果61 626例受试者中，23 826例（10 ~ 10岁），平均年龄为10岁女性占38.7%，60岁以上53202例（86.3%）。共确定了10271名帕金森病患者和51355名对照者。在一个日历年内任何时间诊断的流感与10年后的帕金森病相关（OR，1.73; 95%CI，1.11-2.71）。当流感暴露仅限于流感活动最高的月份时，发现OR升高，置信区间更宽（OR，1.52; 95% CI，0.80-2.89）。没有证据表明与帕金森病前10年以上的任何类型的感染相关（OR，1.04; 95% CI，0.98-1.10）。几个特定的感染产生的帕金森病的几率增加5年内的感染，但结果是无效的，当暴露发生超过10 years previous.Conclusions和相关性在这个病例对照研究中，流感与帕金森病的诊断超过10年后感染。这些观察数据表明流感和帕金森病之间存在联系，但没有证明因果关系。虽然其他感染与感染后不久的帕金森病诊断有关，但超过10年后的零关联表明这些短期关联不是因果关系。
IMPORTANCE Influenza has been associated with the risk of developing Parkinson disease, but the association is controversial.OBJECTIVE To examine whether prior influenza and other infections are associated with Parkinson disease more than 10 years after infection.DESIGN, SETTING, AND PARTICIPANTS This case-control study used data from 1977 to 2016 from the Danish National Patient Registry. All individuals with Parkinson disease, excluding those with drug-induced parkinsonism, were included and matched to 5 population controls on sex, age, and date of Parkinson diagnosis. Data were analyzed from December 2019 to September 2021.EXPOSURES Infections were ascertained between 1977 and 2016 and categorized by time from infection to Parkinson disease diagnosis. To increase specificity of influenza diagnoses, influenza exposure was restricted to months of peak influenza activity.MAIN OUTCOMES AND MEASURES Parkinson disease diagnoses were identified between January 1, 2000, and December 31, 2016. Crude and adjusted odds ratios (ORs) and 95% CIs were calculated by conditional logistic regression overall and stratified by time between infection and Parkinson disease (5 years or less, more than 5 to 10 years, more than 10 years).RESULTS Of 61 626 included individuals, 23 826 (38.7%) were female, and 53 202 (86.3%) were older than 60 years. A total of 10 271 individuals with Parkinson disease and 51 355 controls were identified. Influenza diagnosed at any time during a calendar year was associated with Parkinson disease more than 10 years later (OR, 1.73; 95% CI, 1.11-2.71). When influenza exposure was restricted to months of highest influenza activity, an elevated OR with a wider confidence interval was found (OR, 1.52; 95% CI, 0.80-2.89). There was no evidence of an association with any type of infection more than 10 years prior to Parkinson disease (OR, 1.04; 95% CI, 0.98-1.10). Several specific infections yielded increased odds of Parkinson disease within 5 years of infection, but results were null when exposure occurred more than 10 years prior.CONCLUSIONS AND RELEVANCE In this case-control study, influenza was associated with diagnoses of Parkinson disease more than 10 years after infection. These observational data suggest a link between influenza and Parkinson disease but do not demonstrate causality. While other infections were associated with Parkinson disease diagnoses soon after infection, null associations after more than 10 years suggest these shorter-term associations are not causal.