视网膜血管闭塞诊断后新发帕金森病的风险增加:一项为期 14 年的队列研究

Seung Hoon Kim, Minah Park, Sung Hoon Jeong
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摘要

背景:尽管血管因素在帕金森病病理生理学中的作用已被广泛接受,而且在帕金森病患者中也经常观察到视网膜血管异常,但将视网膜血管疾病与帕金森病发病风险联系起来的证据却很有限。我们的目的是利用全国性队列调查 60 岁以上人群视网膜血管闭塞与帕金森病发病风险之间的关系:方法:从为期 14 年的韩国国民健康保险服务-老年队列中,纳入了 11,210 例视网膜血管闭塞患者和 11,210 例倾向评分、风险匹配的对照组。帕金森病的发病率是通过泊松回归估算出来的。采用 Cox 比例危险回归模型研究视网膜血管闭塞与帕金森病风险之间的关系:结果:在视网膜血管闭塞队列中,帕金森病的发病率为每 10 万人年 664.4 例(95% 置信区间 [CI],599.7-736.0)。视网膜血管闭塞患者帕金森病的发病率增加(危险比 [HR],1.28;95% 置信区间 [CI],1.10-1.49)。帕金森病发病风险增加主要出现在视网膜动脉闭塞患者(HR,1.53;95% CI,1.11-2.12)、男性患者(HR,1.67;95% CI,1.29-2.17)和确诊5年后(HR,1.46;95% CI,1.10-1.93):我们的研究结果表明,视网膜血管闭塞和帕金森病之间可能存在共同的病理生理途径,如血管变化。视网膜血管闭塞可能是帕金森病未来发展的相关风险因素之一。这种关联的性质值得进一步研究。
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Increased Risk of New-Onset Parkinson's Disease Following a Diagnosis of Retinal Vascular Occlusion: A 14-Year Cohort Study.

Background: Although the role of the vascular component in the pathophysiology of Parkinson's disease is widely accepted and retinal vascular abnormalities are commonly observed in Parkinson's disease patients, evidence connecting retinal vascular disorders with the risk of developing Parkinson's disease is limited. We aimed to investigate the association between retinal vascular occlusion (RVO) and the risk of developing Parkinson's disease in people over 60 years using a nationwide cohort.

Methods: From the 14-year South Korean National Health Insurance Service-Senior cohort, 11 210 incident RVO patients and 11 210 propensity scores, risk-matched controls were included. The incidence of Parkinson's disease was estimated with a Poisson regression. A Cox proportional hazards regression model was used to investigate the associations between RVO and the risk of Parkinson's disease.

Results: The incidence of Parkinson's disease was 664.4 cases per 100 000 person-years (95% confidence interval [CI], 599.7-736.0) in the RVO cohort. Individuals with RVO had an increased incidence of Parkinson's disease (hazard ratio [HR], 1.28; 95% CI: 1.10-1.49). Increased PD risk was predominantly observed in retinal artery occlusion patients (HR, 1.53; 95% CI: 1.11-2.12), male patients (HR, 1.67; 95% CI: 1.29-2.17), and 5 years after diagnosis (HR, 1.46; 95% CI: 1.10-1.93).

Conclusions: Our findings suggest that a common pathophysiological pathway, such as vasculature changes, may exist between RVO and Parkinson's disease. RVO may be one of the risk factors associated with future development of Parkinson's disease. The nature of this association warrants further investigation.

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