Reproductive factors, exogenous estrogen use, and risk of Parkinson's disease.

Reproductive factors, exogenous estrogen use, and risk of Parkinson's disease.
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DOI:
10.1002/mds.22619
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发表时间:
2009-07-15
期刊:
影响因子:
8.6
通讯作者:
Ascherio, Alberto
Ascherio, Alberto
中科院分区:
医学1区
文献类型:
--
作者:
Simon, Kelly Claire;Chen, Honglei;Gao, Xiang;Schwarzschild, Michael A.;Ascherio, Alberto

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为了确定生殖因素或外源性雌激素是否与帕金森病 (PD) 风险相关,我们对护士健康研究中的绝经后参与者进行了一项为期 22 年的前瞻性研究。 PD 的相对风险 (RR) 和 95% 置信区间 (CI) 通过 Cox 比例风险模型估计,并调整了潜在的混杂因素。 PD 风险与任何测量的生殖因素或外源性雌激素的使用均无显着相关性。然而,使用绝经后激素可能会改变吸烟和咖啡因摄入与帕金森病风险的关联。在曾经使用过绝经后激素的人群中,吸烟与 PD 风险之间的负相关关系减弱(交互作用 p = 0.05)。咖啡因也获得了类似的结果(相互作用 p = 0.09)。在探索性分析中,发现使用纯孕激素激素的女性 PD 风险增加,但该结果基于极少数病例 (n=4)。在这项大型纵向研究中,我们没有发现任何证据表明外源性或内源性雌激素对 PD 风险有有益影响。绝经后激素的使用可能与其他危险因素相互作用,但研究结果是初步的,需要在其他人群中得到证实。
To determine if reproductive factors or exogenous estrogen are associated with risk of Parkinson’s disease (PD), we conducted a prospective study with 22 years of follow-up among post-menopausal participants in the Nurses’ Health Study. Relative risks (RRs) and 95% confidence intervals (CIs) of PD were estimated from a Cox proportional hazards model adjusting for potential confounders. Risk of PD was not significantly associated with any of the reproductive factors measured or exogenous estrogen use. Use of post-menopausal hormones, however, may modify the associations of smoking and caffeine intake with PD risk. The inverse relation between smoking and PD risk was attenuated among ever users of post-menopausal hormones (p for interaction = 0.05). Similar results were obtained for caffeine (p for interaction = 0.09). In exploratory analyses, women using progestin-only hormones were found to have an increased PD risk, but this result was based on a very small number of cases (n=4). In this large longitudinal study, we found no evidence of a beneficial effect of exogenous or endogenous estrogens on risk of PD. The use of post-menopausal hormone use may interact with other risk factors, but findings are preliminary and need confirmation in other populations.
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