鹿特丹地区膳食脂肪酸和帕金森病发病风险关系的研究

Background: Unsaturated fatty acids are important constituents of neuronal ce ll membranes and have neuroprotective, antioxidant, and anti- inflammatory prop erties. Objective: To determine if a high intake of unsaturated fatty acids migh t be associated with a lower risk of Parkinson disease (PD). Methods: In the Rot terdam Study, a prospective population- based cohort study of people ages ≥ 55 , the association between intake of unsaturated fatty acids and the risk of inci dent PD was evaluated among 5,289 subjects who were free of dementia and parkins onism and underwent complete dietary assessment at baseline. PD was assessed thr ough repeated in- person examination, and the cohort was continuously monitored by computer linkage to medical records. The data were analyzed using Cox propor tional hazards regression models. Results: After a mean follow- up of 6.0 years , 51 participants with incident PD were identified. Intakes of total fat, monoun saturated fatty acids (MUFAs), and polyunsatu rated fatty acids (PUFAs) were significantly associated with a lower risk of PD, with an adjusted hazard ratio per SD increase of energy- adjusted intake of 0.69 (95% CI 0.52 to 0.91) for total fat, of 0.68 (95% CI 0.50 to 0.94) for MUFAs, and 0.66 (95% CI 0.46 to 0.96) for PUFAs. No associations were found f or dietary saturated fat, cholesterol, or trans- fat. Conclusion: These finding s suggest that high intake of unsaturated fatty acids might protect against Park inson disease.

帕金森病的预后:鹿特丹一项关于痴呆和死亡风险的研究

Background: Most prognostic studies on Parkinson disease have been hospital based or have applied register-based casefinding methods. Potential under-representation of mild cases may have given biased results. Abstract:Objective: To evaluate whether Parkinson disease is associated with an increased risk of dementia and death. Design: Population-based cohort study. Parkinson disease and dementia were assessed through in-per-son examination at baseline (1990-1993) and 2 follow-up visits (1993-1994 and 1997-1999). Computerized linkage to medical and municipality records provided additional information on disease outcomes and mortality. Setting: General population. Participants: A total of 6969 participants, including 99 prevalent and 67 incident cases of Parkinson disease. Main Outcome Measures: Incident dementia and death. Adjusted hazard ratios were calculated through Cox proportional hazards regression analysis. Results: Patients with Parkinson disease had an increased risk of dementia (hazard ratio, 2.8; 95%confidence interval, 1.8-4.4), which was especially pronounced in participants carrying at least 1 apolipoprotein E gene (APOE) 2 allele (13.5; 4.5-40.6). Parkinson disease was associated with an increased mortality risk (1.8; 1.5-2.3). The association consistently diminished when analyses were sequentially restricted to patients with shorter disease duration and after adjustment for the occurrence of dementia. Conclusions: Especially patients with Parkinson disease who carry an APOE 2 allele have an increased risk of developing dementia. Increased mortality risk in Parkinson disease is dependent on disease duration and is only modest in the absence of dementia.

普通人群中帕金森综合征和帕金森病的发病率:鹿特丹研究

Objective: To investigate the incidence of parkinsonism and Parkinson disease (PD) in the general population using inperson screening along with clinical data . Methods: In the Rotterdam study, a prospective population based cohort study of people aged ≥55 years, the authors assessed age and sex specific incidence r ates of parkinsonism and PD among 6,839 participants who were free of parkinsoni sm at baseline. Case finding involved in person screening at baseline and two f ollow up visits, and additional information was obtained through continuous mon itoring of the cohort by computer linkage to general practitionersand pharmacy records. Results: After a mean follow up period of 5.8 years, 132 subjects wit h incident parkinsonism were identified, of whom 67 (51%) had PD. The incidence of parkinsonism and PD increased with age, with incidence rates for PD increasi ng from 0.3 per 1000 person years in subjects aged 55 to 65 years, to 4.4 per 1 000 person years for those aged ≥85 years. The overall age adjusted incidence rate of any parkinsonism was not different in men and women, but men seem to ha ve a higher risk for PD (male to female ratio, 1.54; 95%CI, 0.95 to 2.51). Co nclusion: Incidence rates for parkinsonism and Parkinson disease were higher tha n those reported by most previous studies, possibly because of the authorsinte nsive case finding methods involving in person screening.