咖啡因可能降低某些婦女產生巴金森氏症的風險


  Nov. 10, 2004 - 根據一項發表於美國流行病學期刊上的前瞻性世代試驗結果,咖啡因可能降低產生巴金森氏症的風險,但是雌性激素療法可能抑制這個好處。
  
  麻州波士頓哈佛大學公衛學院Alberto Ascherio與其同事指出,咖啡因的使用可以降低男性發生巴金森氏症的機率,但是對女性沒有這樣的效果;這種性別上的差異可能是因為咖啡因與停經後使用荷爾蒙療法之間的交互作用。
  
  透過癌症預防試驗II,一個在1982年收納超過1百萬人的世代試驗,研究者從1989年到1998年的死亡紀錄確定死亡原因;在909位男性與340位女性,巴金森氏症被列為死亡原因。
  
  在校正過年齡、吸菸與喝酒因素後,咖啡因的攝取與男性的巴金森氏症死亡率有關(趨勢P值為.01),但是與女性的死亡率無關(P=.60);在女性,這個關係依賴停經後荷爾蒙療法的使用;相較於不飲用咖啡的,從未使用過荷爾蒙療法,且每天喝4杯以上(600毫升)咖啡女性的相對風險為0.47(95%信賴區間為0.27到0.80;P值為0.006),而使用荷爾蒙療法的為1.31(95%信賴區間為0.75-2.30;P值為0.34)。
  
  研究人員指出,這些結果暗示咖啡因的攝取可以降低巴金森氏症的風險,但是這個理論上的好處可能被荷爾蒙補充療法所遮蓋;這個潛在的交互作用在設計隨機分派試驗時應該被考慮到,而且評估咖啡因或是荷爾蒙對巴金森氏症疾病進程的作用。
  
  該項試驗限制,包括缺乏存活病患有關於巴金森氏症診斷的資訊、追蹤期間咖啡攝取以及雌性激素使用的變化。
  
  國家衛生研究院與Michael J. Fox基金會以及Kinetics基金會贊助這項試驗。

Caffeine May Reduce the Risk o

By Laurie Barclay, MD
Medscape Medical News

Nov. 10, 2004 — Caffeine may reduce the risk of Parkinson's disease but estrogen therapy may inhibit that benefit, according to the results of a prospective cohort study published in the November issue of the American Journal of Epidemiology.

"Caffeine consumption is associated with a reduced risk of Parkinson's disease in men but not in women," write Alberto Ascherio, from the Harvard School of Public Health in Boston, Massachusetts, and colleagues. "This gender difference may be due to an interaction between caffeine and use of postmenopausal estrogens."

Using the Cancer Prevention Study II, a cohort of more than one million people enrolled in 1982, the investigators determined causes of death from death certificates in 1989 through 1998. In 909 men and 340 women, Parkinson's disease was listed as a cause of death.

Coffee consumption was inversely associated with Parkinson's disease mortality in men (P for trend = .01) but not in women (P = .60) after adjustment for age, smoking, and alcohol intake. In women, this association was dependent on postmenopausal estrogen use. Compared with nondrinkers of coffee, the relative risk for women drinking four or more cups (600 mL) of coffee per day was 0.47 (95% confidence interval [CI], 0.27 - 0.80; P = .006) among never-users of estrogen and 1.31 (95% CI, 0.75 - 2.30; P = .34) among users.

"These results suggest that caffeine reduces the risk of Parkinson's disease but that this hypothetical beneficial effect may be prevented by use of estrogen replacement therapy," the authors write. "This potential interaction should be considered in the design of randomized trials assessing the effects of caffeine or estrogen in the progression of Parkinson's disease."

Study limitations include the absence of information on Parkinson's disease diagnoses among surviving participants and on changes in coffee consumption or estrogen use during follow-up.

The National Institutes of Health and the Michael J. Fox Foundation and Kinetics Foundation supported this study.

Am J Epidemiol. 2004;160:977-984

Reviewed by Gary D. Vogin, MD

    
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