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Parkinsonism Relat Disord. 2019 Aug 26. pii: S1353-8020(19)30369-4. doi: 10.1016/j.parkreldis.2019.08.013. [Epub ahead of print]

The relationship between environmental factors and different Parkinson's disease subtypes in Greece: Data analysis of the Hellenic Biobank of Parkinson's disease.

Author information

1
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece; Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Greece.
2
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece.
3
2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece.
4
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece.
5
Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece.
6
Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Greece.
7
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, USA.
8
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Greece; 2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece. Electronic address: lstefanis@bioacademy.gr.

Abstract

INTRODUCTION:

The aim of this study is to investigate the association between environmental factors (smoking, coffee, pesticide exposure) and Parkinson's disease (PD) subtypes (early-onset, mid-and-late onset, familial and sporadic) in the Greek population.

METHODS:

The Hellenic Biobank of PD recorded information of PD cases and controls from two centers in Greece during 2006-2017. Patients with the A53T mutation in SNCA or GBA mutations were excluded. Associations of environmental factors with PD overall (and PD subtypes) versus controls were explored with logistic regression models adjusting for age, gender and each environmental factor.

RESULTS:

686 patients and 356 controls were included. Smoking was associated with a reduced risk of PD overall (OR 0.48, 95% CI 0.35-0.67), mid-and-late onset (0.46, 0.32-0.66), familial (0.53, 0.34-0.83) and sporadic (0.46, 0.32-0.65), but not early-onset PD. There was an inverse linear association with pack-years of smoking, except for early-onset PD. Early-onset PD was the only PD subtype inversely associated with coffee consumption when dichotomously treated. Compared to never-coffee drinkers, only those at the upper tertile had lower odds for PD overall (0.52, 0.29-0.91), early-onset (0.16, 0.05-0.53) and familial PD (0.36, 0.17-0.75). No associations were found between pesticides and PD.

CONCLUSIONS:

Our study shows that the well-known negative association of smoking with PD occurs across all PD subtypes in the Greek population, apart from early-onset PD. Early-onset PD was also most strongly inversely associated with coffee consumption, highlighting a potential distinct underlying physiopathology in this PD subset that may involve specific gene-environment interactions.

KEYWORDS:

Biobank; Coffee; Parkinson's disease; Pesticides; Smoking

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