Beskytter røyking mot Parkinsons sykdom
DOI:
https://doi.org/10.5324/nje.v5i2.261Sammendrag
SAMMENDRAG
Den negative sammenhengen mellom røyking og Parkinsons sykdom i epidemiologiske studier er robust.
Det er prosentvis færre røykere og eks-røykere blant Parkinson-pasienter enn blant kontrollpersoner.
Videre har røykere en lavere insidens og en lavere dødelighet enn andre av Parkinsons sykdom. Det er et
åpent spørsmål om dette skyldes en beskyttende virkning av nikotin eller andre stoffer i tobakksrøyk som
hydrazin eller karbonmonoksid, eller om det skyldes andre, underliggende faktorer. De mest aktuelle slike
faktorer er (1) selektiv dødelighet, altså at mange røykere ikke overlever lenge nok til å utvikle
Parkinsons sykdom, og (2) at personer som utvikler Parkinsons sykdom ofte har karaktertrekk som gjør
det mindre sannsynlig at de begynner å røyke. Det vitenskapelige grunnlaget er i alle fall for tynt for å
anbefale røyking som et forebyggende virkemiddel mot Parkinsons sykdom. Og selv om det skulle vise
seg at røyking virkelig beskytter mot sykdommen, veier de negative helsevirkningene av røyking mye
tyngre i folkehelsesammenheng. Allikevel bør denne assosiasjonen forfølges videre, ikke minst for
potensialet for en bedret forståelse av de underliggende patofysiologiske mekanismene bak sykdommen.
Flaten TP.
Does smoking protect against Parkinson’s disease? Nor J Epidemiol 1995; 5 (2): 145-150.
ENGLISH SUMMARY
It is epidemiologically well established that Parkinson's disease is about twice as common among nonsmokers as among smokers. Whether this is due to a protective effect of nicotine or other compounds in cigarette smoke like hydrazine or carbon monoxide, or whether it is due to some other, confounding factor(s), remains to be established. The most relevant confounding factors are (1) selective mortality, that is, many smokers do not survive long enough to develop Parkinson's disease, and (2) that persons who eventually develop Parkinson's disease tend to have a preclinical personality type that makes them less likely to pick up the smoking habit. In any case, the scientific basis is not strong enough to recommend smoking as a preventive strategy in Parkinson's disease. And even if it were clearly demonstrated that smoking protects against the disease, the known adverse effects of smoking are so serious that any beneficial effects on Parkinson's disease could not possibly compensate for this hazard. However, unraveling the mechanism behind the reduced risk of Parkinson's disease in smokers may provide clues to an improved understanding of the pathophysiological mechanisms behind the disease.
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