Volume 30, Issue 4 p. 552-559
Research Article

Statins, plasma cholesterol, and risk of Parkinson's disease: A prospective study

Xuemei Huang MD, PhD,

Corresponding Author

Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA

Correspondence to: Xuemei Huang, MD, PhD, Department of Neurology, Penn State-Hershey Medical Center, Hershey, PA 17033-0850, E-mail: xuemei@psu.eduSearch for more papers by this author
Alvaro Alonso MD, PhD,

Divisions of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA

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Xuguang Guo PhD,

Westat Inc., Durham, North Carolina, USA

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David M. Umbach PhD,

Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA

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Maya L. Lichtenstein MD,

Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA

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Christie M. Ballantyne MD,

Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, Texas, USA

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Richard B. Mailman PhD,

Departments of Pharmacology and Neurology, Penn State University College of Medicine, Hershey, Pennsylvania, USA

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Thomas H. Mosley PhD,

Department of Medicine (Geriatrics), University of Mississippi Medical Center, Jackson, Mississippi, USA

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Honglei Chen MD, PhD,

Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA

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First published: 14 January 2015
Citations: 72

Funding agencies: : This research was in part supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01-ES-101986). The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C. Dr. Xuemei Huang has been currently supported by NIH grants R01 NS060722, R01 ES019672, and U01 NS082151, and a former award (K23 AG21491) provided support at the conception of this research.

Relevant conflicts of interest/financial disclosures: : Nothing to report.

Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Previous findings on the association of statins, plasma lipids, and Parkinson's disease (PD) are confounded by the fact that statins also affect lipid profiles. We prospectively examined plasma lipids and statin use in relation to PD in the Atherosclerosis Risk in Communities (ARIC) Study. Statin use and plasma lipids were assessed at baseline (visit 1, 1987-89) and at three triennial visits thereafter (visits 2-4) until 1998. Potential PD cases were identified from multiple sources and validated where possible. The primary analysis was limited to incident PD cases diagnosed between 1998 and 2008. Odds ratios and 95% confidence intervals were derived from multivariate logistic regression models. Statin use was rare at baseline (0.57%) but increased to 11.2% at visit 4. During this time frame, total-cholesterol levels decreased, particularly among statin users. Fifty-six PD cases were identified after 1998. Statin use before 1998 was associated with significantly higher PD risk after 1998 (odds ratio = 2.39, 95% confidence interval 1.11-5.13) after adjusting for total cholesterol and other confounders. Conversely, higher total cholesterol was associated with lower risk for PD after adjustment for statin usage and confounders. Compared with the lowest tertile of average total cholesterol, the odds ratios for PD were 0.56 (0.30-1.04) for the second and 0.43 (0.22-0.87) for the third tertile (Ptrend = 0.02). Statin use may be associated with a higher PD risk, whereas higher total cholesterol may be associated with lower risk. These data are inconsistent with the hypothesis that statins are protective against PD. © 2015 International Parkinson and Movement Disorder Society