[P2.055] Statin Use, Apolipoprotein A1, and Parkinson's Disease
Yosef Berlyand,1Roy Alcalay,2Christine Swanson,1Stanley Fahn,2Cheryl Waters,2Oren Levy,2Stephen Schwartz,2Alice Chen-Plotkin1
1Philadelphia, PA, USA, 2New York, NY, USA
OBJECTIVE: To evaluate the association of statin use and Apolipoprotein A1 (ApoA1) levels on age at Parkinson's Disease onset.
BACKGROUND: Epidemiological cohort studies have demonstrated decreased incidence of Parkinson's Disease (PD) among users of statin medications. We have previously shown that higher plasma ApoA1 levels correlate with markers of better dopaminergic system integrity in both manifest PD and in asymptomatic individuals at high risk for PD. Since statins can elevate ApoA1 levels, we investigated here the relationships between statin use, ApoA1 levels, and age at PD onset.
DESIGN/METHODS: We analyzed the association between statin use and age at PD onset in 381 PD patients using linear regression and Cox proportional hazards models. We further analyzed effects in subgroups of lipophilic and hydrophilic statins, since only the former are brain-penetrant. In a convenience subset of 239 PD patients, we measured plasma levels of ApoA1 using a high-throughput immunoturbidity assay. We then evaluated the association of statin use with age at PD onset with and without adjustment for plasma ApoA1 levels.
RESULTS: In a linear regression adjusting for age at plasma sampling and sex, the use of statins was significantly associated with a delayed age at PD onset (p=0.02). This effect was driven by lipid-soluble statins (p=0.005). Similar results were obtained for Cox proportional hazards analyses (hazard ratio 0.71, 95% CI 0.54-0.92, for users of lipid-soluble statins relative to non-users for the development of PD). In the subgroup of patients in whom we had clinical data as well as plasma ApoA1 measures (n=239), we also observed a significant association between statin use and age at PD onset (p=0.04), which weakened slightly (0=0.08) in models that adjusted for plasma ApoA1 levels.
CONCLUSIONS: The use of lipid-soluble statins is associated with a delayed age at PD onset. Adjusting for plasma ApoA1 levels in our model decreased, but did not entirely remove, this association. Lipid-soluble statins may be a promising neuroprotective therapy in PD.
Category - Movement Disorders: Parkinson's Disease
Tuesday, April 29, 2014 7:30 AM
P2: Poster Session II: Movement Disorders: Co-morbidities and Novel Care Models (7:30 AM-11:00 AM)