Reproductive Lifespan and Motor Progression of Parkinson’s Disease
Abstract
:1. Introduction
2. Patients and Methods
2.1. Study Participants
2.2. Determination of Female Reproductive Factors
2.3. Clinical Assessments
2.4. Definition of Faster Motor Progression
2.5. Statistical Analyses
2.6. Data Availability
3. Results
3.1. Baseline Data
3.2. Clinical Outcomes
3.3. Sex Differences in the Progression of PD
3.4. Impact of Reproductive Lifespan on the Motor Progression of Female PD
3.5. Sensitivity Analysis
3.6. Linear Mixed Effect of Reproductive Lifespan
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Sex Group | Reproductive Lifespan Group | |||||
---|---|---|---|---|---|---|---|
Total | Men | Women | Total | Short | Middle | Long | |
Number of samples | n = 1100 | n = 609 | n = 491 | n = 441 | n = 122 | n = 230 | n = 89 |
Number of children | - | - | 1.8 ± 1.0 | 1.8 ± 1.0 | 1.9 ± 1.0 | 1.8 ± 1.1 | 1.6 ± 1.0 |
Age at menarche, years | - | - | 14.5 ± 2.2 | 14.5 ± 2.2 | 16.0 ± 2.6 | 14.3 ± 1.8 | 13.1 ± 1.4 |
Age at menopause, years | - | - | 49.0 ± 4.2 | 49.0 ± 4.2 | 44.7 ± 4.7 | 49.6 ± 1.8 | 53.2 ± 2.2 |
Number of pregnancies | 3.0 ± 1.6 | 3.0 ± 1.6 | 3.2 ± 1.6 | 2.9 ± 1.4 | 2.7 ± 1.8 | ||
Reproductive lifespan, years | - | - | 34.5 ± 4.7 | 34.5 ± 4.7 | 28.7 ± 4.3 | 35.4 ± 1.4 | 40.0 ± 2.0 |
Age at enrollment, years | 61.5 ± 11.2 | 62.1 ± 11.7 | 60.9 ± 10.6 | 62.9 ± 9.1 | 63.1 ± 9.3 | 62.8 ± 9.6 | 62.7 ± 7.2 |
Age of onset, years | 60.0 ± 11.2 | 60.5 ± 11.7 | 59.3 ± 10.6 | 61.3 ± 9.1 | 61.4 ± 9.2 | 61.3 ± 9.7 | 61.1 ± 7.2 |
PD duration at enrollment, years | 1.6 ± 0.8 | 1.6 ± 0.8 | 1.6 ± 0.9 | 1.6 ± 0.9 | 1.6 ± 0.9 | 1.6 ± 0.9 | 1.6 ± 0.9 |
BMI at baseline, kg/m2 | 23.1 ± 2.9 | 23.4 ± 2.8 | 22.6 ± 3.1 | 22.6 ± 3.1 | 22.3 ± 3.1 | 22.4 ± 2.9 | 23.5 ± 3.3 |
Education, years | 9.9 ± 4.2 | 10.5 ± 4.2 | 9.2 ± 4.1 | 9.3 ± 4.1 | 8.2 ± 4.3 | 9.6 ± 4.0 | 10.0 ± 4.2 |
Smoking | 294 (26.7%) | 290 (34.3%) | 4 (0.01%) | 2 (0.5%) | 0 | 1 (0.4%) | 1 (1.1%) |
Dysautonomia | 329 (29.9%) | 191 (3.1%) | 138 (28.3%) | 134 (30.4%) | 39 (32.0%) | 75 (32.6%) | 20 (22.5%) |
RBD | 340 (30.9%) | 201 (33.0%) | 139 (28.3%) | 130 (29.5%) | 35 (28.7%) | 71 (30.9%) | 24 (27.0%) |
Hypertension | 232 (21.1%) | 137 (22.5%) | 95 (19.3%) | 94 (21.3%) | 27 (22.1%) | 42 (18.3%) | 25 (28.1%) |
Diabetes mellitus | 84 (7.6%) | 50 (8.2%) | 34 (6.9%) | 34 (7.7%) | 12 (9.8%) | 17 (7.4%0 | 5 (5.6%) |
PD family history | 117 (10.6%) | 64 (10.5%) | 53 (10.8%) | 47 (10.7%) | 13 (10.7%) | 24 (10.4%) | 10 (11.2%) |
LEDD at baseline, mg/day | 197.7 ± 220.8 | 199.3 ± 204.6 | 195.8 ± 239.9 | 199.7 ± 243.6 | 225.6 ± 327.1 | 189.1 ± 195.9 | 191.8 ± 220.3 |
MoCA at baseline | 23.9 ± 4.3 | 24.3 ± 4.0 | 23.5 ± 4.5 | 23.4 ± 4.6 | 22.5 ± 4.9 | 23.6 ± 4.5 | 23.8 ± 4.1 |
HAMD at baseline | 9.0 ± 7.8 | 8.1 ± 7.2 | 10.1 ± 8.4 | 9.9 ± 8.1 | 10.9 ± 8.2 | 9.8 ± 8.2 | 8.9 ± 7.7 |
HAMA at baseline | 6.7 ± 6.2 | 5.9 ± 5.6 | 7.6 ± 6.7 | 7.7 ± 6.6 | 8.6 ± 6.4 | 7.7 ± 7.0 | 6.3 ± 5.8 |
Number of deaths during follow-up | 119 (10.8%) | 78 (12.8%) | 41 (10.0%) | 41 (9.3%) | 7 (5.7%) | 28 (12.2%) | 6 (6.7%) |
Survival time from symptoms onset, years | 5.6 ± 2.4 | 5.6 ± 2.5 | 5.6 ± 2.3 | 5.6 ± 2.3 | 5.4 ± 2.3 | 5.6 ± 2.3 | 6.0 ± 2.5 |
UDPRS III at baseline | 25.5 ± 11.6 | 27.1 ± 11.4 | 23.5 ± 11.5 | 23.7 ± 11.5 | 23.8 ± 11.3 | 23.9 ± 11.4 | 23.1 ± 12.1 |
Change in UPDRS III | 8.1 ± 11.7 | 7.6 ± 11.9 | 8.7 ± 11.6 | 8.7 ± 11.5 | 9.8 ± 11.0 | 8.3 ± 11.9 | 8.1 ± 11.2 |
Faster motor progression | 201 (18.3%) | 100 (16.4%) | 101 (20.6%) | 90 (20.4%) | 32 (26.2%) | 44 (19.1%) | 14 (15.7%) |
Observation time for UPDRS III, years | 4.0 ± 2.3 | 4.1 ± 2.4 | 3.9 ± 2.2 | 3.9 ± 2.2 | 3.6 ± 2.0 | 4.0 ± 2.1 | 4.2 ± 2.6 |
H&Y stage at baseline | 1.9 ± 0.4 | 2.0 ± 0.4 | 1.9 ± 0.5 | 1.9 ± 0.5 | 1.9 ± 0.4 | 1.9 ± 0.5 | 1.8 ± 0.5 |
Baseline Characteristics | UPDRS III Increase of ≥16 Points | ||||||||
---|---|---|---|---|---|---|---|---|---|
Total Participants | Female Population | Patients Who Experienced Menopause after PD Onset | |||||||
SHR | 95% CI | p-Value | SHR | 95% CI | p-Value | SHR | 95% CI | p-Value | |
Female sex | 0.888 | 0.652–1.209 | 0.450 | ||||||
Reproductive lifespan | 0.964 | 0.936–0.994 | 0.019 * | 0.156 | 0.045–0.542 | 0.003 * | |||
Age at enrollment | 1.095 | 0.919–1.306 | 0.310 | 1.004 | 0.780–1.292 | 0.980 | 0.891 | 0.358–2.216 | 0.800 |
Age of onset | 0.901 | 0.757–1.073 | 0.240 | 0.998 | 0.773–1.288 | 0.990 | 1.166 | 0.507–2.684 | 0.720 |
BMI | 0.961 | 0.913–1.010 | 0.120 | 0.948 | 0.878–1.024 | 0.180 | 0.984 | 0.823–1.176 | 0.860 |
Smoking history | 0.493 | 0.329–1.739 | 0.610 | ||||||
Diabetes mellitus | 1.132 | 0.659–1.945 | 0.650 | 1.007 | 0.415–2.442 | 0.990 | |||
Hypertension | 0.852 | 0.574–1.264 | 0.430 | 0.763 | 0.418–1.394 | 0.380 | |||
MoCA | 0.985 | 0.951–1.021 | 0.410 | 1.004 | 0.976–1.030 | 0.760 | 1.085 | 0.918–1.282 | 0.340 |
Dysautonomia | 0.923 | 0.668–1.274 | 0.620 | 0.822 | 0.514–1.314 | 0.410 | 0.829 | 0.269–2.555 | 0.740 |
RBD | 0.830 | 0.612–1.124 | 0.230 | 0.960 | 0.599–1.537 | 0.860 | 0.231 | 0.038–1.404 | 0.110 |
UPDRS III | 0.960 | 0.947–0.973 | <0.001 * | 0.950 | 0.930–0.969 | <0.001 * | 0.927 | 0.859–1.001 | 0.052 |
UPDRS III Score at the Last Visit | ||||
---|---|---|---|---|
Estimated Effect (β) | Standard Error (SE) | t | p-Value | |
Reproductive lifespan | −0.512 | 0.228 | −2.242 | 0.026 * |
Follow-up time in years | 1.012 | 1.585 | 0.639 | 0.524 |
Reproductive lifespan × Follow-up time in years | 0.010 | 0.045 | 0.219 | 0.827 |
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Ou, R.; Wei, Q.; Hou, Y.; Zhang, L.; Liu, K.; Lin, J.; Yang, T.; Yang, J.; Jiang, Z.; Song, W.; et al. Reproductive Lifespan and Motor Progression of Parkinson’s Disease. J. Clin. Med. 2022, 11, 6163. https://doi.org/10.3390/jcm11206163
Ou R, Wei Q, Hou Y, Zhang L, Liu K, Lin J, Yang T, Yang J, Jiang Z, Song W, et al. Reproductive Lifespan and Motor Progression of Parkinson’s Disease. Journal of Clinical Medicine. 2022; 11(20):6163. https://doi.org/10.3390/jcm11206163
Chicago/Turabian StyleOu, Ruwei, Qianqian Wei, Yanbing Hou, Lingyu Zhang, Kuncheng Liu, Junyu Lin, Tianmi Yang, Jing Yang, Zheng Jiang, Wei Song, and et al. 2022. "Reproductive Lifespan and Motor Progression of Parkinson’s Disease" Journal of Clinical Medicine 11, no. 20: 6163. https://doi.org/10.3390/jcm11206163
APA StyleOu, R., Wei, Q., Hou, Y., Zhang, L., Liu, K., Lin, J., Yang, T., Yang, J., Jiang, Z., Song, W., Cao, B., & Shang, H. (2022). Reproductive Lifespan and Motor Progression of Parkinson’s Disease. Journal of Clinical Medicine, 11(20), 6163. https://doi.org/10.3390/jcm11206163