title: Midlife adiposity and the future risk of Parkinson's disease.
abstract: BACKGROUND
  Evidence suggests that nigrostriatal system disorders are associated with PD and adiposity. Whether patterns of adiposity coexist or predate clinical PD is unknown. This report examines the relation between midlife adiposity and the risk of PD.
  
  
  METHODS
  Measurement of adiposity occurred from 1965 to 1968 in 7,990 men in the Honolulu Heart Program (aged 45 to 68 years and without PD). Adiposity measures included body mass index (BMI), subscapular skinfold thickness (SSF), and triceps skinfold thickness (TSF). Follow-up for incident PD occurred over a 30-year period.
  
  
  RESULTS
  During the course of follow-up, PD was observed in 137 men. Among the measures of adiposity, age-adjusted incidence of PD increased threefold from 3.7/10,000 person-years in the bottom quartile of TSF (1 to 5 mm) to 11.1/10,000 person-years in the top quartile (11 to 32 mm, p < 0.001). Effects of TSF on PD were independent of cigarette smoking, coffee consumption, physical activity, daily caloric and fat intake, and the other measures of adiposity (p < 0.001). Whereas rates of PD were lowest in the bottom quartile of BMI and SSF vs higher quartiles, associations with PD were weaker than they were for TSF. The effect of TSF on clinical onset before age 65 years was similar to the effect that was observed in later life.
  
  
  CONCLUSIONS
  Increased triceps skinfold thickness measured in midlife is associated with an elevated risk of future PD. Whether patterns of adiposity reflect a unique metabolic pathology in individuals at a high risk of PD warrants further study.
authors.affiliation: Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, USA. rda3e@virginia.edu
authors.forename: R D
authors.initials: RD
authors.lastname: Abbott
authors.forename: G W
authors.initials: GW
authors.lastname: Ross
authors.forename: L R
authors.initials: LR
authors.lastname: White
authors.forename: J S
authors.initials: JS
authors.lastname: Nelson
authors.forename: K H
authors.initials: KH
authors.lastname: Masaki
authors.forename: C M
authors.initials: CM
authors.lastname: Tanner
authors.forename: J D
authors.initials: JD
authors.lastname: Curb
authors.forename: P L
authors.initials: PL
authors.lastname: Blanchette
authors.forename: J S
authors.initials: JS
authors.lastname: Popper
authors.forename: H
authors.initials: H
authors.lastname: Petrovitch
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016001:Confidence Intervals; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D010300:Parkinson Disease / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016016:Proportional Hazards Models; D012307:Risk Factors