研究课题：咖啡因消耗量与男生/女性帕金森症（PD）发病风险的前瞻性研究
供稿：营养系，哈佛公共卫生学院，波士顿

    主要内容：病例对照研究和在男性人群中完成的前瞻性研究结果均显示，饮用咖啡可以降低PD发病风险，但其活性成分尚不明了。为了证实咖啡因就是活性成分的假设，我们分别研究了咖啡及咖啡因消耗量与PD发病风险的关系。病例来自2个正在进行的研究单位，即卫生专家随访组(HPFS)和护理卫生组(NHS)。研究人群包括47351名男性和88565名女性，均无基础性PD病、中风和癌症。研究开始所有参与者完成了一份生活习惯和饮食食谱的问卷调查，然后每个2-4年更新一次。随后的随访中（男性10年，女性16年），共诊断出288例PD患者。 男性人群中，经过年龄和吸烟因素校正后，咖啡因摄入量最高的1/5人群与咖啡因摄入量最低的1/5人群比较，其PD相对风险为0.42(95%CI:0.23-0.78;p<0.001)；类似的反相关也见于咖啡摄入者（p=0.004），非咖啡来源咖啡因摄入者(p< 0.001)，以及引用茶叶者(p=0.02)，但不见于脱咖啡因咖啡饮用者。对于女性而言，咖啡或者咖啡因摄入量与PD相对风险之间的关系呈U字形，症等咖啡摄入量的发病风险最低。（每天1-3杯咖啡，或者第三咖啡因摄入）。上述结果表明可能中等剂量的咖啡因对于PD发病具有保护效应。

    结论：饮用咖啡可以降低PD发病风险。

Prospective study of caffeine consumption and risk of Parkinson's disease in men and women.
Ascherio A, Zhang SM, Hernan MA, Kawachi I, Colditz GA, Speizer FE, Willett WC. Ann Neurol. 2001 Jul;50(1):56-63.
Department of Nutrition, Harvard School of Public Health, Boston, MA.

    Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in two ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every two to four years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23-0.78; p for trend < 0.001) for men in the top one-fifth of caffeine intake compared to those in the bottom one-fifth. An inverse association was also observed with consumption of coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend < 0.001), and tea (p for trend = 0.02) but not decaffeinated coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1-3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease.

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