Olfaction and incident Parkinson disease in US white and black older adults
Olfaction and incident Parkinson disease in US white and black older adults
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DOI：
10.1212/wnl.0000000000004382
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发表时间：
2017-10-03
期刊：
影响因子：
9.9
通讯作者：
Harris, Tamara B.
中科院分区：
文献类型：
--
作者：
Chen, Honglei;Shrestha, Srishti;Harris, Tamara B.
目的：探讨嗅觉与美国白人和黑人老年人帕金森病（PD）发病的关系。方法：该研究包括1510名白人（平均年龄75.6岁）和952名黑人（75.4岁）的健康、衰老和身体成分研究参与者。我们在1999-2000年用简短气味识别测试（BSIT）评估了研究参与者的嗅觉。我们使用多个数据来源对2012年8月31日之前发现的PD病例进行回顾性裁决。我们使用多变量Cox模型来估计风险比（hr）和95%置信区间（ci）。结果：在平均9.8年的随访中，我们共发现42例PD病例，包括30例白人和12例黑人参与者。总的来说，嗅觉差，正如较低的BSIT分数所表明的那样，与PD的高风险相关。与BSIT最高分位（t3）相比，第二分位（t2）的HR为1.3 (95% CI 0.5 ~ 3.6)，最低分位（t1）的HR为4.8 (95% CI 2.0 ~ 11.2) （p(trend) < 0.00001）。进一步的分析显示，在随访的前5年（HRt1/[t2+t3] 4.2, 95% CI 1.7-10.8）和随访后（HRt1/[t2+t3] 4.1, 95% CI 1.7-9.8）， PD发生率均有显著相关性。白人（HRt1/[t2+t3] 4.9, 95% CI 2.3-10.5）比黑人（HRt1/[t2+t3] 2.5, 95% CI 0.8-8.1），男性（HRt1/[t2+t3] 5.4, 95% CI 2.3-12.9）比女性（HRt1/[t2+t3] 2.9, 95% CI 1.1-7.8）更强。结论：嗅觉差是PD中短期的预测指标；男性和白人参与者之间更强联系的可能性值得进一步调查。
Objective: To investigate olfaction in relation to incident Parkinson disease (PD) in US white and black older adults.Methods: The study included 1,510 white (mean age 75.6 years) and 952 black (75.4 years) participants of the Health, Aging, and Body Composition study. We evaluated the olfaction of study participants with the Brief Smell Identification Test (BSIT) in 1999-2000. We retrospectively adjudicated PD cases identified through August 31, 2012, using multiple data sources. We used multivariable Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: During an average of 9.8 years of follow-up, we identified a total of 42 incident PD cases, including 30 white and 12 black participants. Overall, poor sense of smell, as indicated by a lower BSIT score, was associated with higher risk of PD. Compared with the highest tertile of BSIT (t3), the HR was 1.3 (95% CI 0.5-3.6) for the second tertile (t2) and 4.8 (95% CI 2.0-11.2) for the lowest tertile (t1) (p(trend) < 0.00001). Further analyses revealed significant associations for incident PD in both the first 5 years of follow-up (HRt1/[t2+t3] 4.2, 95% CI 1.7-10.8) and thereafter (HRt1/[t2+t3] 4.1, 95% CI 1.7-9.8). This association appeared to be stronger in white (HRt1/[t2+t3] 4.9, 95% CI 2.3-10.5) than in black participants (HRt1/[t2+t3] 2.5, 95% CI 0.8-8.1), and in men (HRt1/[t2+t3] 5.4, 95% CI 2.3-12.9) than in women (HRt1/[t2+t3] 2.9, 95% CI 1.1-7.8).Conclusions: Poor olfaction predicts PD in short and intermediate terms; the possibility of stronger associations among men and white participants warrants further investigation.