More Than 28 Cups of Coffee a Week May Endanger Health in Under 55s

Nearly 400 million cups of coffee are consumed every day in America. Drinking large amounts of coffee may be bad for under-55s, according to a new study published in Mayo Clinic Proceedings. A study of more than 40,000 individuals found a statistically significant 21% increased mortality in those drinking more than 28 cups of coffee a week and death from all causes, with a greater than 50% increased mortality risk in both men and women younger than 55 years of age. Investigators warn that younger people in particular may need to avoid heavy coffee consumption. No adverse effects were found in heavy coffee drinkers aged over 55.

 

Drinking coffee has become a normal daily routine for large numbers of people worldwide. According to the latest National Coffee Drinking Study from the National Coffee Association, more than 60% of American adults drink coffee every day, consuming on average just over three cups a day.
Coffee has long been suspected to contribute to a variety of chronic health conditions, although earlier studies on coffee consumption in relation to deaths from all causes and deaths from coronary heart disease are limited, and the results are often controversial.
A multicenter research team investigated the effect of coffee consumption on death from all causes and deaths from cardiovascular disease in the Aerobics Center Longitudinal Study (ACLS) cohort, with an average follow-up period of 16 years and a relatively large sample size of over 40,000 men and women.
Between 1979 and 1998, nearly 45,000 individuals aged between 20 and 87 years old participated and returned a medical history questionnaire assessing lifestyle habits (including coffee consumption) and personal and family medical history. The investigators examined a total of 43,727 participants (33,900 men and 9,827 women) in their final analysis.
During the 17-year median follow-up period there were 2,512 deaths (men: 87.5%; women: 12.5%), 32% of these caused by cardiovascular disease. Those who consumed higher amounts of coffee (both men and women) were more likely to smoke and had lower levels of cardiorespiratory fitness.
All participants were followed from the baseline examination to date of death or until December 31, 2003. Deaths from all causes and deaths from cardiovascular disease were identified through the National Death Index or by accessing death certificates.
Younger men had a trend towards higher mortality even at lower consumption, but this became significant at about 28 cups per week where there was a 56% increase in mortality from all causes. Younger women who consumed more than 28 cups of coffee per week also had a greater than 2-fold higher risk of all-cause mortality than those who did not drink coffee.
Senior investigator Steven H. Blair, PED, of the Department of Biostatistics and Epidemiology, Arnold School of Public Health, University of South Carolina, emphasizes that "Significantly, the results did not demonstrate any association between coffee consumption and all-cause mortality among older men and women. It is also important to note that none of the doses of coffee in either men or women whether younger or older had any significant effects on cardiovascular mortality."
Coffee is a complex mixture of chemicals consisting of thousands of components. Recent research has found that coffee is one of the major sources of antioxidants in the diet and has potential beneficial effects on inflammation and cognitive function. However, it is also well-known that coffee has potential adverse effects because of caffeine's potential to stimulate the release of epinephrine, inhibit insulin activity, and increase blood pressure and levels of homocysteine.
"Thus, all of these mechanisms could counterbalance one another. Research also suggests that heavy coffee drinkers may experience additional risk through potential genetic mechanisms or because of confounding through the deleterious effects of other risk factors with which coffee drinking is associated," say lead authors, Junxiu Liu, MD, Department of Biostatistics and Epidemiology, and Xuemei Sui, MD, MPH, PhD, Department of Exercise Science, both at the Arnold School of Public Health, University of South Carolina, "Therefore, we hypothesize that the positive association between coffee and mortality may be due to the interaction of age and coffee consumption, combined with a component of genetic coffee addiction."
The investigators suggest that younger people in particular should avoid heavy coffee consumption of more than 28 cups a week or four cups in a typical day. However, they emphasize that further studies are needed in different populations to assess details regarding the effects of long-term coffee consumption and changes in coffee consumption over time on all-cause and cardiovascular disease mortality.
Leading expert Carl J. Lavie, MD, of the Department of Cardiovascular Diseases, Ochsner Medical Center, New Orleans, and a co-author of this study, explains that "There continues to be considerable debate about the health effects of caffeine, and coffee specifically, with some reports suggesting toxicity and some even suggesting beneficial effects."
 

Journal Reference:

1. Junxiu Liu, Xuemei Sui, Carl J. Lavie, James R. Hebert, Conrad P. Earnest, Jiajia Zhang, Steven N. Blair. Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality. Mayo Clinic Proceedings, 2013; DOI: 10.1016/j.mayocp.2013.06.020

Courtesy: ScienceDaily
 

Soft Drinks Linked to Behavioral Problems in Young Children

Americans buy more soft drinks per capita than people in any other country. These drinks are consumed by individuals of all ages, including very young children. Although soft drink consumption is associated with aggression, depression, and suicidal thoughts in adolescents, the relationship had not been evaluated in younger children. A new study scheduled for publication in The Journal of Pediatrics finds that aggression, attention problems, and withdrawal behavior are all associated with soft drink consumption in young children.

Shakira Suglia, ScD, and colleagues from Columbia University's Mailman School of Public Health, University of Vermont, and Harvard School of Public Health assessed approximately 3,000 5-year-old children enrolled in the Fragile Families and Child Wellbeing Study, a prospective birth cohort that follows mother-child pairs from 20 large U.S. cities. Mothers reported their child's soft drink consumption and completed the Child Behavior Checklist based on their child's behavior during the previous two months. The researchers found that 43% of the children consumed at least 1 serving of soft drinks per day, and 4% consumed 4 or more.
Aggression, withdrawal, and attention problems were associated with soda consumption. Even after adjusting for sociodemographic factors, maternal depression, intimate partner violence, and paternal incarceration, any soft drink consumption was associated with increased aggressive behavior. Children who drank 4 or more soft drinks per day were more than twice as likely to destroy things belonging to others, get into fights, and physically attack people. They also had increased attention problems and withdrawal behavior compared with those who did not consume soft drinks,
According to Dr. Suglia, "We found that the child's aggressive behavior score increased with every increase in soft drinks servings per day." Although this study cannot identify the exact nature of the association between soft drink consumption and problem behaviors, limiting or eliminating a child's soft drink consumption may reduce behavioral problems.
 

Journal Reference:

1. Shakira F. Suglia, Sara Solnick, and David Hemenway. Soft Drinks Consumption Is Associated with Behavior Problems in 5-Year-Olds. The Journal of Pediatrics, 2013 DOI: 10.1016/j.jpeds.2013.06.023

Courtesy: ScienceDaily
 

Six Months of Fish Oil Reverses Liver Disease in Children With Intestinal Failure, Study Shows.

Children who suffer from intestinal failure, most often caused by a shortened or dysfunctional bowel, are unable to consume food orally. Instead, a nutritional cocktail of sugar, protein and fat made from soybean oil is injected through a small tube in their vein.

For these children, the intravenous nutrition serves as a bridge to bowel adaptation, a process by which the intestine recovers and improves its capacity to absorb nutrition. But the soybean oil, which provides essential fatty acids and calories, has been associated with a potentially lethal complication known as intestinal failure-associated liver disease, which may require a liver and/or intestinal transplant. Such a transplant can prevent death, but the five-year post-transplant survival rate is only 50 percent.
Previous studies have shown that replacing soybean oil with fish oil in intravenous nutrition can reverse intestinal failure-associated liver disease. However, the necessary duration of fish oil treatment had not been established in medical studies.
Now, a clinical trial conducted at the Children's Discovery and Innovation Institute at Mattel Children's Hospital UCLA has found that, compared with soybean oil, a limited duration (24 weeks) of fish oil is safe and effective in reversing liver disease in children with intestinal failure who require intravenous nutrition. The researchers believe that fish oil may also decrease the need for liver and/or intestinal transplants -- and mortality -- associated with this disease.
The researchers' study, "Six Months of Intravenous Fish Oil Reverses Pediatric Intestinal Failure Associated Liver Disease," is published online in the Journal of Parenteral and Enteral Nutrition.
"With this particular study, we set out to determine if a finite period of six months of intravenous fish oil could safely reverse liver damage in these children, and we have had some promising results," said lead author Dr. Kara Calkins, an assistant professor in the department of pediatrics in the division of neonatology and developmental biology at UCLA. "But because intravenous fish oil is not yet approved by the Food and Drug Administration and is much more costly than soybean oil, it is typically not covered by insurance. As a result, this oil is considered experimental and is currently available only under special protocols. If it proves safe and effective for patients, we hope it would eventually be available for wider use."
For the study, intravenous soybean oil was replaced with intravenous fish oil in 10 patients between the ages of 2 weeks and 18 years who had advanced intestinal failure-associated liver disease and who were at high risk for death and/or transplant. The researchers compared these subjects with 20 historical controls who had received soybean oil.
Results showed that the children receiving fish oil had a much higher rate of reversal of liver disease than those who received the standard soybean oil. In fact, after 17 weeks of fish oil, nearly 80 percent of patients experienced a reversal of their liver disease, while only 5 percent of the soybean patients saw a reversal.
The next phase of research will involve following children for up to five years after they stop fish oil to determine if their liver disease returns and if transplant rates are truly decreased, the study authors said.
"We are also trying to better understand how fish oil reverses this disease by investigating changes in proteins and genes in the blood and liver," Calkins said. "These studies will provide the scientific and medical community with a better understanding of this disease and how intravenous fish oil works."
For Isabella Piscione, who was one of the first patients at UCLA to receive the fish oil treatment under compassionate use, her outcome with the treatment paved the way for researchers to establish the six-month protocol. Because of multiple surgeries due to an obstruction in her intestines, Isabella was left with only 10 centimeters of intestine. She depended on intravenous nutrition for survival, which unfortunately resulted in liver damage.
When Isabella started the fish oil treatment, she was just over 6 months old and was listed for a liver and bowel transplant. Within a month of starting the treatment, her condition started to improve. By six months, her liver had healed, and she no longer needed a transplant.
"We cried tears of joy each week that we saw her getting better and better," said her father, Laureano Piscione. "She is a success story."
 

Journal Reference:

1. K. L. Calkins, J. C. Y. Dunn, S. B. Shew, L. Reyen, D. G. Farmer, S. U. Devaskar, R. S. Venick. Pediatric Intestinal Failure-Associated Liver Disease Is Reversed With 6 Months of Intravenous Fish Oil. Journal of Parenteral and Enteral Nutrition, 2013; DOI: 10.1177/0148607113495416

Courtesy: ScienceDaily
 

Long-Sought Method to Efficiently Make Complex Anticancer Compound Developed

Scientists at The Scripps Research Institute (TSRI) have achieved the first efficient chemical synthesis of ingenol, a highly complex, plant-derived compound that has long been of interest to drug developers for its anticancer potential. The achievement will enable scientists to synthesize a wide variety of ingenol derivatives and investigate their therapeutic properties. The achievement also sets the stage for the efficient commercial production of ingenol mebutate, a treatment for actinic keratosis (a common precursor to non-melanoma skin cancer), that at present must be extracted and refined inefficiently from plants.

"I think that most organic chemists had considered ingenol beyond the reach of scalable chemical synthesis," said TSRI Professor Phil S. Baran. Baran and his laboratory report their achievement in this week's issue of Science Express, the early online edition of the journal Science.
An Anticancer Substance from Nature
Ingenol and its derivatives are found in the widely distributed Euphorbia genus of plant, whose milky sap has long been used in traditional medicine to treat skin lesions. Ingenol mebutate, extracted from the common "petty spurge" plant (E. peplus), was recently approved by the U.S. FDA, European Medicines Agency, Medicines Australia and Health Canada to treat actinic keratosis, a common type of precancerous lesion associated with cumulative sun exposure. Formulated and marketed as Picato®, the drug has also shown effects in models and in early trials of non-melanoma skin cancers.
In late 2011, the drug's manufacturer, Denmark-based LEO Pharma, collaborated with Baran's laboratory to find an efficient way to synthesize ingenol mebutate using organic chemistry -- the usual method for producing modern drugs. "At the time, the only way to get the product was by a relatively lengthy extraction process from the E. peplus plant," said Michael Sierra, LEO Pharma's director of external discovery. "We were hoping to get a more efficient synthetic route for production, as well as a method that would allow us to make new derivatives."
Studies have shown that ingenol mebutate, which is applied topically, can treat precancerous skin cells with unusual swiftness, while sparing healthy skin cells. The treatment has a direct cancer-cell-killing effect, and also induces an inflammatory reaction. Researchers suspect that derivatives of ingenol mebutate may be useful in treating other types of cancer, if they can be delivered properly.
Until now, it was debatable whether such derivatives could ever be synthesized. Some prominent researchers have suggested recently that the efficient chemical synthesis of structurally unusual "terpenoid" compounds such as ingenol is an unreachable goal -- and that drug developers should seek biotechnology solutions instead. Even leading scientists of LEO Pharma initially had their doubts. "It was initially hard for me to sell this project to the company," said Sierra. "But I knew Phil, and I knew that his lab could do this."
Achieving the 'Unreachable' Goal
Baran and his team started by examining what is known about ingenol's natural synthesis in plant cells. "A key feature of the natural synthesis is that the basic framework of the molecule is built first, and then in a second phase the important oxygenated functional groups are added," said Steven J. McKerrall, a graduate student in the laboratory who was one of the two first authors of the study.
Following that basic strategy of mimicking nature, McKerrall, Baran and their colleagues began designing the synthesis. They were eventually able to hone the process to 14 steps, starting from a common and inexpensive chemical, carene, and ending with long-sought ingenol. "Syntheses of ingenol have been described in the past, but they all require more than 37 steps," said co-lead author Lars Jørgensen, a postdoctoral fellow in the Baran Laboratory.
The new and concise synthesis turned out to yield relatively large quantities of ingenol, making it an efficient approach to the production of ingenol mebutate and other ingenol derivatives. The two-phase design also provides a significant amount of a key intermediate compound, which enables the efficient preparation of various ingenol derivatives. "We won't have to go through the entire synthesis every time we need to make a new ingenol derivative; we can start synthesizing from this intermediate compound," said Jørgensen.
Sierra and others at LEO Pharma were pleased with the project's outcome. "It's a pretty amazing feat: the total synthesis of ingenol within a year and a half of starting our collaboration," he said. "It's great to work with a research group like this."
To Baran, the achievement serves also as an emphatic rejoinder to those who had declared chemical synthesis a dead-end technique for making such complex natural compounds. "With this study we rebut that argument conclusively," he said. "And there are many other complex natural compounds waiting to be synthesized using a strategy like ours -- this is really just a glimpse of the future of chemical synthesis."
 

Journal Reference:

1. Lars Jørgensen, Steven J. McKerrall, Christian A. Kuttruff, Felix Ungeheuer, Jakob Felding, and Phil S. Baran. 14-step synthesis of ( )-ingenol from ( )-3-carene. Science, 1 August 2013 DOI: 10.1126/science.1241606

Courtesy: ScienceDaily
 

As Climate, Disease Links Become Clearer, Study Highlights Need to Forecast Future Shifts

Climate change is affecting the spread of infectious diseases worldwide, according to an international team of leading disease ecologists, with serious impacts to human health and biodiversity conservation. Writing in the journal Science, they propose that modeling the way disease systems respond to climate variables could help public health officials and environmental managers predict and mitigate the spread of lethal diseases.

The issue of climate change and disease has provoked intense debate over the past decade, particularly in the case of diseases that affect humans, according to the University of Georgia's Sonia Altizer, who is the study's lead author.

"For a lot of human diseases, responses to climate change depend on the wealth of nations, healthcare infrastructure and the ability to take mitigating measures against disease," said Altizer, an associate professor in the UGA Odum School of Ecology. "The climate signal, in many cases, is hard to tease apart from other factors like vector control and vaccine and drug availability."
Climate warming already is causing changes in diseases affecting wildlife and agricultural ecosystems, she said. "In many cases, we're seeing an increase in disease and parasitism. But the impact of climate change on these disease relationships depends on the physiology of the organisms involved, the location on the globe and the structure of ecological communities."
At the organism level, climate change can alter the physiology of both hosts and parasites. Some of the clearest examples are found in the Arctic, where temperatures are rising rapidly, resulting in faster developing parasites. A lungworm that affects muskoxen, for instance, can now be transmitted over a longer period each summer, making it a serious problem for the populations it infects.
"The Arctic is like a 'canary in the global coal mine,'" said co-author Susan Kutz of the University of Calgary and Canadian Cooperative Wildlife Health Centre.
"Climate warming in the Arctic is occurring more rapidly than elsewhere, threatening the health and sustainability of Arctic plants and animals, which are adapted to a harsh and highly seasonal environment and are vulnerable to invasions by 'southern' species -- both animals and parasites."
A changing climate also is affecting entire plant and animal communities. This is particularly evident in tropical marine environments such as the world's coral reef ecosystems. In places like the Caribbean, warmer water temperatures have stressed corals and facilitated infections by pathogenic fungi and bacteria. When corals -- the framework builders of the ecosystem -- succumb, the myriad of species that depend on them are also at risk.
"Biodiversity loss is a well-established consequence of climate change," said coauthor Richard Ostfeld of the Cary Institute of Ecosystem Studies. "In a number of infectious disease systems, such as Lyme disease and West Nile virus, biodiversity loss is tied to greater pathogen transmission and increased human risk. Moving forward, we need models that are sensitive to both direct and indirect effects of climate change on infectious disease."
Where human health is concerned, there is not only the direct risk from pathogens like dengue, malaria and cholera, all of which are linked to warmer temperatures, but indirect risks from threats to agricultural systems and game species crucial for subsistence and cultural activities.
"Earth's changing climate and the global spread of infectious diseases are threatening human health, agriculture and wildlife. Solving these problems requires a comprehensive approach that unites scientists from biology, the geosciences and the social sciences," said Sam Scheiner, National Science Foundation program director for the joint NSF-National Institutes of Health Ecology and Evolution of Infectious Diseases Program.
The study was funded in part by the National Science Foundation.
"We need to transcend simple arguments about which is more important -- climate change or socioeconomics -- and ask just how much harder will it be to control diseases as the climate warms?" Ostfeld said. "Will it be possible at all in developing countries?"
To respond to that challenge, Altizer and her colleagues -- Kutz, Ostfeld, Pieter T. J. Johnson of the University of Colorado Boulder and C. Drew Harvell of Cornell University -- laid out an agenda for future research and action.
One recommendation is to expand data about the physiological responses hosts and parasites have to temperature changes to help develop early warning systems.
"We'd like to be able to predict, for example, that if the climate warms by a certain amount, then in a particular host-parasite system we might see an increase from one to two transmission cycles per year," Altizer said. "But we'd also like to try to tie these predictions to actions that might be taken."
Such forecasting is well established in crop disease management and has been used to both preventatively close coral reefs and target areas at risk of malaria outbreaks.
"We face a tough task in the oceans, where disease outbreaks can be out of sight and undetected," Harvell said. "Because some coral disease outbreaks are predictable from warming events, we are developing forecasting programs to help us respond before the outbreak begins."
The researchers also pointed out that certain human communities, such as those of indigenous peoples in the Arctic, could be disproportionately impacted by climate-disease interactions.
"A better understanding of the impacts of parasitism on wildlife health, and an ability to make accurate predictions of future wildlife sustainability, is particularly important to aboriginal people across the Arctic who depend on wildlife as a source of food, income and a focus of cultural activities," Kutz said.
Johnson continued, "Because disease represents the product of multiple interacting species, including hosts, pathogens and other members of the food web, forecasting responses to ongoing climate shifts is a tremendous challenge," he said. "Given the rising importance of infectious diseases not only for human health but also wildlife conservation, it's also a challenge for which we are in sore need of a solution. We hope our work contributes to that."
 

Journal Reference:

1. S. Altizer, R. S. Ostfeld, P. T. J. Johnson, S. Kutz, C. D. Harvell. Climate Change and Infectious Diseases: From Evidence to a Predictive Framework. Science, 2013; 341 (6145): 514 DOI: 10.1126/science.1239401

Courtesy: ScienceDaily
 

New Water Splitting Technique Efficiently Produces Hydrogen Fuel

A University of Colorado Boulder team has developed a radically new technique that uses the power of sunlight to efficiently split water into its components of hydrogen and oxygen, paving the way for the broad use of hydrogen as a clean, green fuel.

The CU-Boulder team has devised a solar-thermal system in which sunlight could be concentrated by a vast array of mirrors onto a single point atop a central tower up to several hundred feet tall. The tower would gather heat generated by the mirror system to roughly 2,500 degrees Fahrenheit (1,350 Celsius), then deliver it into a reactor containing chemical compounds known as metal oxides, said CU-Boulder Professor Alan Weimer, research group leader. As a metal oxide compound heats up, it releases oxygen atoms, changing its material composition and causing the newly formed compound to seek out new oxygen atoms, said Weimer. The team showed that the addition of steam to the system -- which could be produced by boiling water in the reactor with the concentrated sunlight beamed to the tower -- would cause oxygen from the water molecules to adhere to the surface of the metal oxide, freeing up hydrogen molecules for collection as hydrogen gas.
"We have designed something here that is very different from other methods and frankly something that nobody thought was possible before," said Weimer of the chemical and biological engineering department. "Splitting water with sunlight is the Holy Grail of a sustainable hydrogen economy."
A paper on the subject was published in the Aug. 2 issue of Science. The team included co-lead authors Weimer and Associate Professor Charles Musgrave, first author and doctoral student Christopher Muhich, postdoctoral researcher Janna Martinek, undergraduate Kayla Weston, former CU graduate student Paul Lichty, former CU postdoctoral researcher Xinhua Liang and former CU researcher Brian Evanko.
One of the key differences between the CU method and other methods developed to split water is the ability to conduct two chemical reactions at the same temperature, said Musgrave, also of the chemical and biological engineering department. While there are no working models, conventional theory holds that producing hydrogen through the metal oxide process requires heating the reactor to a high temperature to remove oxygen, then cooling it to a low temperature before injecting steam to re-oxidize the compound in order to release hydrogen gas for collection.
"The more conventional approaches require the control of both the switching of the temperature in the reactor from a hot to a cool state and the introduction of steam into the system," said Musgrave. "One of the big innovations in our system is that there is no swing in the temperature. The whole process is driven by either turning a steam valve on or off."
"Just like you would use a magnifying glass to start a fire, we can concentrate sunlight until it is really hot and use it to drive these chemical reactions," said Muhich. "While we can easily heat it up to more than 1,350 degrees Celsius, we want to heat it to the lowest temperature possible for these chemical reactions to still occur. Hotter temperatures can cause rapid thermal expansion and contraction, potentially causing damage to both the chemical materials and to the reactors themselves."
In addition, the two-step conventional idea for water splitting also wastes both time and heat, said Weimer, also a faculty member at CU-Boulder's BioFrontiers Institute. "There are only so many hours of sunlight in a day," he said.
The research was supported by the National Science Foundation and by the U.S. Department of Energy.
With the new CU-Boulder method, the amount of hydrogen produced for fuel cells or for storage is entirely dependent on the amount of metal oxide -- which is made up of a combination of iron, cobalt, aluminum and oxygen -- and how much steam is introduced into the system. One of the designs proposed by the team is to build reactor tubes roughly a foot in diameter and several feet long, fill them with the metal oxide material and stack them on top of each other. A working system to produce a significant amount of hydrogen gas would require a number of the tall towers to gather concentrated sunlight from several acres of mirrors surrounding each tower.
Weimer said the new design began percolating within the team about two years ago. "When we saw that we could use this simpler, more effective method, it required a change in our thinking," said Weimer. "We had to develop a theory to explain it and make it believable and understandable to other scientists and engineers."

Despite the discovery, the commercialization of such a solar-thermal reactor is likely years away. "With the price of natural gas so low, there is no incentive to burn clean energy," said Weimer, also the executive director of the Colorado Center for Biorefining and Biofuels, or C2B2. "There would have to be a substantial monetary penalty for putting carbon into the atmosphere, or the price of fossil fuels would have to go way up."
C2B2 is an arm of the Colorado Energy Research Collaboratory involving CU-Boulder, the Colorado School of Mines, Colorado State University and the National Renewable Energy Laboratory in Golden. The collaboratory works with industry partners, public agencies and other institutions to commercialize renewable energy technologies, support economic growth in the state and nation and educate the future workforce.

Journal Reference:

1. C. L. Muhich, B. W. Evanko, K. C. Weston, P. Lichty, X. Liang, J. Martinek, C. B. Musgrave, A. W. Weimer. Efficient Generation of H2 by Splitting Water with an Isothermal Redox Cycle. Science, 2013; 341 (6145): 540 DOI: 10.1126/science.1239454

Courtesy: ScienceDaily

Stopping Cholesterol Drugs May Be Associated With Increased Risk of Parkinson's

People who stop taking cholesterol drugs may be at an increased risk for developing Parkinson's disease, according to research that appears in the July 24, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology. Previous studies on the relationship between cholesterol drugs called statins and the risk of Parkinson's disease have had inconsistent results.

The current study involved 43,810 people in Taiwan who were taking statins and did not have Parkinson's disease. Taiwan's compulsory national health insurance program reimbursement policy requests that doctors stop prescribing statins once the patient's cholesterol reaches the treatment goal, which is contrary to standard treatment in the United States. "This policy allowed us to see whether there was any difference in the risk of Parkinson's in people who stopped taking statins compared to the ones who kept taking them," said study author Jou-Wei Lin, MD, PhD, of National Taiwan University in Taipei.
The study found a difference between two types of statins. The use of lipophilic, or fat-soluble, statins such as simvastatin and atorvastatin was associated with a reduced risk of Parkinson's, while no such association was found for hydrophilic, or water-soluble, statins such as pravastatin and rosuvastatin.
Those who stopped taking the fat-soluble statins were 58 percent more likely to develop Parkinson's disease than those who kept taking the drugs, an absolute risk of 2.65 cases per one million person-days. This result was consistent even after adjusting for other conditions such as diabetes and high blood pressure.
The study also looked at how many people taking the two types of statins developed Parkinson's disease, compared to the number of person-days spent on the medication to come up with an incidence rate. A total of 25 people taking fat-soluble statins developed Parkinson's from a total of nearly 15 million person-days on the drugs, for a rate of 1.68 cases per one million person-days on the drugs. For the water-soluble statins, 14 people developed Parkinson's from nearly four million person-days on the drugs, for a rate of 3.52 cases per one million person-days on the drugs.
"The fat-soluble statins are better able to cross the blood-brain barrier than the water-soluble statins," Lin said.
The study was supported by the Taiwan Ministry of Education.
 

Journal Reference:

1. Yen-Chieh Lee, Chin-Hsien Lin, Ruey-Meei Wu, Min-Shung Lin, Jou-Wei Lin, Chia-Hsuin Chang, Mei-Shu Lai. Discontinuation of statin therapy associates with Parkinson disease: A population-based study. Neurology, 2013; DOI: 10.1212/WNL.0b013e31829d873c

Courtesy: ScienceDaily