@article {Portugal10.1212 / WNL。0000000000207424,作者= {Berta葡萄牙和范妮玆哲和伊莎贝尔Degaey Emmanuel罗兹和艾格尼丝·弗尔涅蒋禄卡Severi和玛丽安Canonico和C {\ ' e} cile Proust-Lima和Alexis巴兹},title ={协会女性的身体活动和帕金森病:长期随访的E3N队列研究},elocation-id = {10.1212 / WNL。={2023}0000000000207424},年,doi = {10.1212 / WNL。出版商0000000000207424}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标:之前的队列研究报道,一个测量的身体活动(PA)在基线评估是降低帕金首页森{\ textquoteright}疾病发病率(PD),但一个荟萃分析表明这种关联是局限于男性。由于疾病的前驱期长,反向因果关系不能排除作为一个可能的解释。我们的目标是研究时变PA和PD使用滞后分析之间的关系来解决潜在的反向因果关系,和之前比较PA轨迹的病人诊断和匹配控制。方法:我们使用数据从E3N(1990 - 2018),一个队列研究的女性隶属于国家健康保险计划的人在教育工作。爸爸是自我报告的后续六个调查问卷。随着问卷问题发生了变化,我们创建了一个时变潜伏PA (LPA)变量使用潜在过程混合模型。PD确定使用多步验证过程是基于医疗记录,或基于药物声称的验证算法。我们设置一个嵌套病例对照研究来考察LPA轨迹的差异使用多变量线性混合模型和回顾的时间尺度。Cox比例风险模型随着年龄的时间表和调整混杂因素被用来估计时变LPA和PD发病率之间的关系。 Our main analysis used a 10y-lag to account for reverse causation; sensitivity analyses used 5y, 15y, and 20y-lags.Results: Analyses of trajectories (1,196 cases, 23,879 controls) showed that LPA was significantly lower in cases than in controls throughout the follow-up, including 29y before diagnosis; the difference between cases and controls started to increase \~{}10y before diagnosis (P-interaction=0.003). In our main survival analysis, of 95,354 women free of PD in 2000, 1,074 women developed PD over a mean follow-up of 17.2y. PD incidence decreased with increasing LPA (P-trend=0.001), with 25\% lower incidence in those in the highest quartile compared to the lowest (adjusted hazard ratio=0.75, 95\% confidence interval=0.63-0.89). Using longer lags yielded similar conclusions.Discussion: Higher PA level is associated with lower PD incidence in women, not explained by reverse causation. These results are important for planning interventions for PD prevention.}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/early/2023/05/17/WNL.0000000000207424}, eprint = {//www.ez-admanager.com/content/early/2023/05/17/WNL.0000000000207424.full.pdf}, journal = {Neurology} }
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