Risk factors for Parkinson disease and the path analysis: One-to-one paired design

Xianhua Tan

摘要：BACKGROUND: Parkinson disease (PD) results from the reduce of neurotransmitter dopamine that transmits intracellular information in brain caused by some reasons, then leads to the dynamic disequilibrium with another neurotransmitter of acetylcholine which is relatively hyperactive. The main causes for PD are still unclear.OBJECTIVE: To screen out the risk factors of PD by means of univariate analysis and multivariate Logistic regression analysis, and investigate the manner of actions between various factors and PD, so as to provide clues for the etiological study of PD.DESIGN: A paired design, Logistic regression analysis, path analysis.SETTING: Department of Scientific Research, Shandong Institute of Physical Education.PARTICIPANTS: Totally 157 PD patients were selected from the Department of Neurology, Qilu Hospital of Shandong University from November 2001 to October 2002. Inclusive criteria: PD was diagnosed according to the standard set by the Fourth National Seminar on Extrapyramidal Disease, Parkinsonian syndromes caused by stroke, carbon monoxide poisoning, encephalitis, drugs, etc. were excluded. Another 157 patients treated in the same department at the same period were selected as the control group, they were the same in sex as those in the patient group, within 3 years older or younger than those in the patient group,and without PD or other extrapyramidal diseases.social behavioral factor, environmental factor, genetic factor, life events, and previous disease; There were 12 main variables, including educational level, family history, mental labour, contact to insecticides, living place before school-age, smoking index, drinking index, tea-drinking index, history of brain trauma, history of SPSS 10.0 software were used in the conditional Logistic regression analysis and path analysis respectively.MAIN OUTCOME MEASURES: The results of 12-variable univariate and multivariate analyses;Correlation between main variables and PD; Effects of the factors.analysis showed that family history, mental labour, insecticides, drinking index and history of depression all had significant positive correlations with PD (univariate analysis: OR=1.405- 5.429, P ＜ 0.05- 0.01;multivariate analysis: OR=2.029- 6.754, P ＜ 0.05- 0.01), whereas smoking had significant negative correlations with PD [univariate analysis: odd ratio (OR)=0.765, P ＜ 0.05; multivariate analysis: OR =0.489,and history of depression had direct effects on PD occurrence [(path coefficient= - 0.218 to 0.204, P ＜ 0.05- 0.01)]; Insecticides could cause PD indirectly on the basis of family history (genetic susceptibility) (path coefficient=0.946, P ＜ 0.01); Insecticides could also cause PD by drinking (path coefficient=0.165, P ＜ 0.01);Drinking could cause PD indirectly on the basis of family history (path coefficient=0.043, P ＜ 0.01).CONCLUSION: The main risk factors of PD are family history, history of depression, drinking, mental labour and insecticides, whereas the protective factor is smoking. PD attack has genetic susceptibility,insecticides and drinking can cause PD on the basis of PD family history. The risk of PD can be decreased by reducing the occasion for contacting the environmental risk factors.