JAMA Netw Open:做好这两点,帕金森病患者全因死亡风险骤降65%!

2022-08-22 MedSci原创 MedSci原创

 JAMA Netw Open:饮食和身体活动与帕金森病成人全因死亡率的关系

生活方式行为,包括饮食和身体活动,与罹患帕金森病(PD)的风险有关,帕金森病是第二常见的神经退行性疾病。例如,根据替代健康饮食指数(AHEI)和替代地中海饮食(aMED)评分评估的更好的饮食质量,以及更高水平的身体活动与PD 事件和前驱PD症状的风险较低相关。然而,人们对它们在PD生存中的长期作用知之甚少。

尽管PD运动症状的临床管理有所改善,但几乎没有证据表明目前的治疗方法可以减缓进行性神经元丢失。因此,本研究旨在探索来自2个大型美国队列的PD患者,护士健康研究(NHS)和卫生专业人员随访研究(HPFS))的诊断前和诊断后整体饮食质量和身体活动与全因死亡率的关系。研究人员假设更好的饮食质量和更高水平的身体活动单独和共同有助于更好的PD生存。

这项基于人群的队列研究分析了1986年-2012年卫生专业人员随访研究中的男性参与者以及1984年-2012年护士健康研究中的女性参与者。纳入被诊断患有PD并具有完整基线饮食评估数据的受试者。从20211月到20222月对数据进行了分析。采用Cox比例风险回归模型,单独和联合估计饮食和体力活动与死亡率的相关性,并根据年龄、总能量摄入、咖啡因摄入量和其他生活方式危险因素对模型进行调整。

PD患者1251例,其中652例(52.1%),诊断时中位(IQR)年龄为73.467.5~78.7岁)。在3234年的随访中,有942名参与者死亡。比较最高与最低AHEI四分位数的调整后风险比(HR)在诊断前分析中为0.6995%CI0.56-0.85),在诊断后分析中为0.5795%CI0.42-0.78)。

在诊断前分析(HR0.71;95% CI0.57-0.87)和诊断后分析(HR0.47;95% CI0.35-0.63)中,每周累积平均 MET 小时数也获得了类似的结果。PD特异性死亡率的负相关持续存在(诊断后AHEIHR0.52 [95% CI 0.33-0.80];诊断后体力活动:HR0.37 [95% CI 0.25-0.55])。

PD诊断前的饮食质量和身体活动的联合分析中,两个变量的最高与最低三阶梯度的个体的调整HR0.5195%CI0.36-0.73)。诊断后饮食质量和身体活动的HR0.3595%CI0.23-0.52)。

这项队列研究是迄今为止调差未来队列中PD患者的整体饮食质量和身体活动与生存的关系最大的一项研究。遵循更健康的饮食模式,如AHEI,并在PD诊断之前和之后参加频繁的体育活动与较低的死亡率有关。即使在控制了诊断前水平之后,诊断后饮食质量和身体活动仍然与较低的死亡率显着相关。

总的来说,健康的饮食模式和积极的生活方式与PD患者全因死亡率的降低有关。

 

原文来源:

Zhang X, Molsberry SA, Schwarzschild MA, Ascherio A, Gao X. Association of Diet and Physical Activity With All-Cause Mortality Among Adults With Parkinson Disease. JAMA Netw Open. 2022;5(8):e2227738. doi:10.1001/jamanetworkopen.2022.27738

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    2023-04-19 canlab
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    2023-04-08 feather89
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    2022-08-21 肿瘤克星

    JAMA上文章都是顶级的,谢谢梅斯及时上新

    0

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