乳制品摄入对中国55岁及以上人群帕金森病前驱期风险影响的前瞻性队列研究

Effects of dairy products intake on prodromal Parkinson’s disease in Chinese adults aged 55 and above: A prospective cohort study

[背景]国外有报道高水平的乳制品摄入量会增加帕金森病(PD)发生风险,但缺乏对帕金森病前驱期(pPD)的探索,国内上述领域研究均较少。[目的]开展我国四省55岁及以上人群乳制品摄入与pPD风险关联的前瞻性研究。[方法]数据来源于“神经系统疾病专病社区队列研究”项目,选取参与了2018年基线和2020年随访两轮调查,并具有完整的基线人口学基本信息、膳食调查及两轮PD风险因素筛查数据的55岁及以上人群,共9984人。根据国际帕金森病和运动障碍协会研究标准评估研究对象的pPD风险水平及相关风险/前驱标志数,应用食物频率问卷调查获得过去12个月的食物消费数据,计算乳制品摄入量并分为未摄入组和摄入量三等分组(从低到高分别为T1、T2、T3)。采用多重线性回归模型分析基线乳制品摄入量与随访pPD风险水平的关系;采用Poisson回归模型和多项logit回归模型分析基线乳制品摄入量与随访pPD风险/前驱标志数的关联;应用多因素logistic回归分析基线乳制品摄入与随访pPD各个风险/前驱标志的关联。[结果]2018年有58.02%的55岁及以上人群在过去一年没有摄入乳制品的习惯;女性、55~74岁、初中及以上文化程度、家庭月收入≥1000元、居住在城市及无工作的人群乳制品摄入较多(P<0.05)。2020年pPD风险水平中位数为0.74%,66.74%的研究对象有3~5个风险/前驱标志。多重线性回归分析显示基线乳制品摄入量与随访pPD风险水平无关联性;Poisson回归分析中基线乳制品摄入较高水平组(T3,中位数为250.00 g·d^(-1))在随访时存在pPD风险/前驱标志的可能性是未摄入组的1.159(95%CI:1.065~1.261)倍(P_(趋势)<0.001);而将标志数分组后,多项logit回归分析未发现具有统计学意义的关联。[结论]虽然我国四省55岁及以上人群中较高的乳制品摄入水平可能与存在pPD风险/前驱标志相关,但本研究未发现乳制品摄入与pPD风险水平直接相关。

[Background] It has been reported that a high intake of dairy products might be associated with an increased risk of Parkinson’s disease(PD) in foreign studies, but no such study has yet been conducted on prodromal Parkinson’s disease(pPD) and the Chinese population.[Objective] To investigate the prospective relationship between the intake of dairy products and pPD among people aged 55 and above in four provinces of China.[Methods] The research data were obtained from the baseline 2018 and follow-up 2020 surveys of Community-based Cohort Study on Nervous System Disease. A total of 9 984 residents were selected who participated in both waves of surveys and had complete data on demographics, dietary products intake, and risk factors for PD. We evaluated the risk level and the numbers of related risk/prodromal markers of pPD in the participants based on a criteria recommended by the International Parkinson and Movement Disorder Society(MDS). Food Frequency Questionnaire was used to obtain food consumption data in the past 12 months, and the intake of dairy products was calculated and divided into non-consumption and tertiles of consumption(T1, T2, and T3 from low to high). Multiple linear regression was used to analyze the association between baseline dairy intake and risk level of follow-up pPD. Poisson regression and multinomial logit regression models were used to analyze the relationship of baseline dairy products and the number of risk/prodromal markers of follow-up pPD in the population, and multiple logistic regression was used to analyze each risk/prodromal marker of follow-up pPD according to baseline levels of dairy products intake.[Results] The percentage of residents without dairy products consumption was 58.02% in 2018, and the dairy products intakes were relatively high among residents being female, aged 55 to 74 years, with an education level of middle school and above, with a per capita monthly household income ≥ 1 000 yuan, living in urban areas, and without active employment(P < 0.05). The median risk level of pPD was 0.74% in 2020, and the proportion of residents with 3 to 5 markers was 66.74%. The multiple linear regression analysis results suggested no association between baseline dairy intake and follow-up risk level of pPD. The Poisson regression model showed that the high dairy products intake group at baseline(T3, median=250.00 g·d^(-1)) was found to be 1.159(95%CI: 1.065~1.261, P_(trend)< 0.001) times more likely to have the risk/prodromal markers of pPD at follow-up than non-consumers. When the number of markers was grouped, no statistically significant association was found by multiple logistic regression analysis.[Conclusion] Although high dairy products intake levels might be associated with pPD risk/prodromal markers among people aged 55 and above in four provinces of China, no direct association is found between dairy products intake and pPD risk levels in this study.