研究课题：吸烟、饮酒和饮用咖啡与PD相关：病例对照研究
供稿：卫生科学研究和神经学系，Mayo诊所及基金会

    主要内容：目的：采用病例对照研究方法，研究吸烟、饮酒和饮用咖啡等因素与PD的关系。

    方法：我们采用了罗切斯特流行病课题连接系统的临床病历资料，在Olmsted镇从1976年到1995年共找到196例PD病人。每一例病人都从一般人群中寻找了年龄（±1岁）和性别匹配的对照。作者详细总结了病人及对照个体的病历记录，以便找到有用的相关信息。结果：关于饮用咖啡，我们发现饮用者必从未饮用的人在发病风险（OR：0.35 , 95% CI = 0.16 -0.78, p = 0.01），剂量效应(p = 0.003)，以及始发年龄(中位数分别为72岁和64岁， p = 0.0002).等方面均存在明显差异。用教育、吸烟、饮酒等因素校正后，饮用咖啡与PD发病的负相关性仍然存在，但仅限于72岁以前发病的男性人群。 吸烟者PD发病风险指数为0.69 (95% CI = 0.45 -1.08, p = 0.1)。而饮酒与PD发病无关。罕见行为，如咀嚼烟叶、使用鼻烟、酗酒等，反而在对照人群中更为常见。

    结论：我们的结果提示在咖啡消耗量与PD发病之间存在负相关。咖啡能够间接预防PD发病。

Smoking, alcohol, and coffee consumption preceding Parkinson’s disease:
A case-control study. Benedetti M, Bower J, Maraganore D, McDonnell S, et al. Neurology 2000;55:1350-1358
Departments of Health Sciences Research and Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN.

OBJECTIVE: To study the association of PD with preceding smoking, alcohol, and coffee consumption using a case-control design. METHODS: The authors used the medical records linkage system of the Rochester Epidemiology Project to identify 196 subjects who developed PD in Olmsted County, MN, during the years 1976 to 1995. Each incident case was matched by age (±1 year) and sex to a general population control subject. The authors reviewed the complete medical records of cases and control subjects to abstract exposure information. RESULTS: For coffee consumption, the authors found an OR of 0.35 (95% CI = 0.16 to 0.78, p = 0.01), a dose–effect trend (p = 0.003), and a later age at PD onset in cases who drank coffee compared with those who never did (median 72 versus 64 years; p = 0.0002). The inverse association with coffee remained significant after adjustment for education, smoking, and alcohol drinking and was restricted to PD cases with onset at age <72 years and to men. The OR for cigarette smoking was 0.69 (95% CI = 0.45 to 1.08, p = 0.1). The authors found no association between PD and alcohol consumption. Extreme or unusual behaviors such as tobacco chewing or snuff use and a diagnosis of alcoholism were significantly more common in control subjects than cases. CONCLUSIONS: These findings suggest an inverse association between coffee drinking and PD; however, this association does not imply that coffee has a direct protective effect against PD. Alternative explanations for the association should be considered.

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