Parkinson's disease, smoking, and family history. EUROPARKINSON Study Group.
There is growing evidence that both genetic and environmental factors play a role in the etiology of Parkinson's disease (PD). The hypothesis of an interaction between genetic and environmental risk factors has been little explored, and never using a population-based case-control study design. Our objective was to investigate the possible interaction between smoking and family history in the etiology of PD, as part of a collaborative population-based case-control study. We included 149 nondemented PD patients ascertained in three European prevalence surveys using a two-phase design. Each patient was matched by age (+/-2 years), gender, and center to three controls drawn from the same populations (n=375). Presence of PD among first-degree relatives and smoking history were assessed through an interview for 127 cases and 306 controls. In the overall sample we found suggestive evidence that family history and ever-smoking interact in determining the risk of PD (P=0.09), with individuals exposed to both risk factors having the highest risk (OR=10.0; 95% CI=2.0-49.6). Analyses were repeated after stratification into two age-groups (cutoff: 75 years). In older patients, the joint exposure to both risk factors was associated with a significant increase in the risk of PD (OR=17.6; 95% CI=1.9-160.5). Among younger subjects, the OR for joint exposure was not significant. In conclusion, our findings suggest that smoking and family history interact synergistically on a multiplicative scale in determining the risk of PD in individuals older than 75 years.
Elbaz
A
A
INSERM U 360, Recherches Epidémiologiques en Neurologie et Psychopathologie, H pital de la Salpêtrière, Paris, France. elbaz@ccr.jussieu.fr
Manubens-Bertran
J M
JM
Baldereschi
M
M
Breteler
M M
MM
Grigoletto
F
F
Lopez-Pousa
S
S
Dartigues
J F
JF
Alpérovitch
A
A
Rocca
W A
WA
Tzourio
C
C
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*