Use of ibuprofen and risk of Parkinson disease
Use of ibuprofen and risk of Parkinson disease
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DOI：
10.1212/wnl.0b013e31820f2d79
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发表时间：
2011-03-01
期刊：
影响因子：
9.9
通讯作者：
Ascherio, Alberto
中科院分区：
文献类型：
--
作者：
Gao, Xiang;Chen, Honglei;Ascherio, Alberto
背景：神经炎症可能参与帕金森病（PD）的发病机制。在以前的流行病学研究中，一般使用非甾体抗炎药（NSAID），特别是可能使用布洛芬，与降低PD风险有关。方法：我们前瞻性地研究了在136名受试者中，护士健康研究（NHS）和卫生专业人员随访研究（HPFS）的197例受试者在基线时无PD（NHS为1998年，HPFS为2000年）。通过问卷调查评估NSAID的使用情况。将结果与已发表的前瞻性研究结果进行荟萃分析。结果：在6年的随访期间，我们发现了291例PD事件。布洛芬使用者的PD风险显著低于非使用者（经年龄、吸烟、咖啡因和其他协变量校正的相对风险[RR]= 0.62; 95%置信区间[CI] 0.42-0.93; p = 0.02）。每周服用布洛芬片剂与PD风险之间存在剂量-反应关系（p趋势= 0.01）。相反，PD风险与阿司匹林（RR = 0.99; 95% CI 0.78-1.26）、其他NSAID（RR = 1.26; 95% CI 0.86-1.84）或对乙酰氨基酚（RR = 0.86; 95% CI 0.62-1.18）的使用无显著相关性。在荟萃分析中获得了相似的结果：合并RR为0.73（95%CI 0.63-0.85; p < 0.0001），而使用其他类型的镇痛药与较低的PD风险无关。使用布洛芬与降低PD风险之间的相关性，与其他NSAID或对乙酰氨基酚不同，提示布洛芬作为一种潜在的抗PD神经保护剂应进一步研究。神经病学（R）2011; 76：863-869
Background: Neuroinflammation may contribute to the pathogenesis of Parkinson disease (PD). Use of nonsteroidal anti-inflammatory drugs (NSAID) in general, and possibly ibuprofen in particular, has been shown to be related to lower PD risk in previous epidemiologic studies.Methods: We prospectively examined whether use of ibuprofen or other NSAIDs is associated with lower PD risk among 136,197 participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS) free of PD at baseline (1998 for NHS and 2000 for HPFS). NSAIDs use was assessed via questionnaire. Results were combined in a meta-analysis with those of published prospective investigations.Results: We identified 291 incident PD cases during 6 years of follow-up. Users of ibuprofen had a significantly lower PD risk than nonusers (relative risk [RR], adjusted for age, smoking, caffeine, and other covariates = 0.62; 95% confidence interval [CI] 0.42-0.93; p = 0.02). There was a dose-response relationship between tablets of ibuprofen taken per week and PD risk (p trend = 0.01). In contrast, PD risk was not significantly related to use of aspirin (RR = 0.99; 95% CI 0.78-1.26), other NSAIDs (RR = 1.26; 95% CI 0.86-1.84), or acetaminophen (RR = 0.86; 95% CI 0.62-1.18). Similar results were obtained in the meta-analyses: the pooled RR was 0.73 (95% CI 0.63-0.85; p < 0.0001) for ibuprofen use, whereas use of other types of analgesics was not associated with lower PD risk.Conclusions: The association between use of ibuprofen and lower PD risks, not shared by other NSAIDs or acetaminophen, suggests ibuprofen should be further investigated as a potential neuroprotective agent against PD. Neurology (R) 2011; 76: 863-869