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Midlife adiposity and the future risk of Parkinson’s disease

From the Division of Biostatistics and Epidemiology (Dr. Abbott), University of Virginia School of Medicine, Charlottesville; Pacific Health Research Institute (Drs. Abbott, Ross, White, Nelson, Masaki, Curb, and Petrovitch), Honolulu, HI; Department of Veterans Affairs (Drs. Ross, White, and Petrovitch), Honolulu, HI); Kuakini Medical Center and the Honolulu–Asia Aging Study (Drs. Abbott, Ross, White, Masaki, Curb, Blanchette, Popper, and Petrovitch), Honolulu, HI; Departments of Geriatric Medicine and Medicine (Drs. Abbott, Ross, White, Masaki, Curb, Blanchette, and Petrovitch), University of Hawaii John A. Burns School of Medicine, Honolulu, HI; and the Parkinson’s Institute (Drs. Ross and Tanner), Sunnyvale, CA.

Address correspondence and reprint requests to Dr. Robert D. Abbott, University of Virginia Health System, Department of Health Evaluation Sciences, P.O. Box 800717, Charlottesville, VA 22908-0717; e-mail: rda3e{at}virginia.edu

Background: Evidence suggests that nigrostriatal system disorders are associated with PD and adiposity. Whether patterns of adiposity coexist or predate clinical PD is unknown. This report examines the relation between midlife adiposity and the risk of PD.

Methods: Measurement of adiposity occurred from 1965 to 1968 in 7,990 men in the Honolulu Heart Program (aged 45 to 68 years and without PD). Adiposity measures included body mass index (BMI), subscapular skinfold thickness (SSF), and triceps skinfold thickness (TSF). Follow-up for incident PD occurred over a 30-year period.

Results: During the course of follow-up, PD was observed in 137 men. Among the measures of adiposity, age-adjusted incidence of PD increased threefold from 3.7/10,000 person-years in the bottom quartile of TSF (1 to 5 mm) to 11.1/10,000 person-years in the top quartile (11 to 32 mm, p < 0.001). Effects of TSF on PD were independent of cigarette smoking, coffee consumption, physical activity, daily caloric and fat intake, and the other measures of adiposity (p < 0.001). Whereas rates of PD were lowest in the bottom quartile of BMI and SSF vs higher quartiles, associations with PD were weaker than they were for TSF. The effect of TSF on clinical onset before age 65 years was similar to the effect that was observed in later life.

Conclusions: Increased triceps skinfold thickness measured in midlife is associated with an elevated risk of future PD. Whether patterns of adiposity reflect a unique metabolic pathology in individuals at a high risk of PD warrants further study.

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