Lincoln County Hospital, Lincoln, UK; University of Nottingham, UK.
Parkinsonism Relat Disord. 2012 Sep;18(8):964-70. doi: 10.1016/j.parkreldis.2012.05.004. Epub 2012 Jun 8.
To study the relationship between olfaction and body weight profile in Parkinson's disease.
Prospective assessment of 99 PD patients for clinical parameters, olfaction using UPSIT and current and previous body weight. Patients were categorised as weight losers (WL) and non-weight losers (NWL) depending on change of weight from previous years. Olfaction was categorised into two groups at the cut-off of the median level of UPSIT scores. Data was analysed to study the relationship of olfaction on weight change.
Thirty-nine were weight losers (WL) and 60 non-weight losers (NWL). WL were significantly older (p = 0.02), females (p = 0.03) and had more severe impairment of olfaction, UPSIT 15 ± 4 vs 19 ± 5; p < 0.004. Patients with more severe olfaction (anosmic) impairment were older (p = 0.001) and had significantly lower weight, 75 vs 83 kg, p = 0.01. There was no difference in the proportion of smokers, medication usage, difficult swallowing or calorie consumption in any group. Weight losers and severe olfaction loss were associated with more severe H&Y stage. Patients below the median-UPSIT (anosmic) had lost weight during the previous years whereas those above the median (hyposmic) had gained weight. Regression analysis revealed UPSIT at the median level to be the most significant variable (p < 0.001) for weight loss. There was continuous loss of olfaction with increasing disease severity. Higher olfactory loss was associated with higher risk of dyskinesia.
Early assessment of olfaction may identify patients of different phenotypes for weight change and risk of dyskinesia during the course of the disease.
研究帕金森病患者嗅觉与体重变化的关系。
前瞻性评估 99 例帕金森病患者的临床参数、使用 UPSIT 进行嗅觉评估以及当前和既往体重。根据体重与前几年相比的变化，患者分为体重减轻者（WL）和非体重减轻者（NWL）。根据 UPSIT 评分中位数的截点将嗅觉分为两组。分析数据以研究嗅觉与体重变化的关系。
39 例为体重减轻者（WL），60 例为非体重减轻者（NWL）。WL 组年龄较大（p=0.02）、女性比例较高（p=0.03）、嗅觉障碍更严重，UPSIT 为 15±4 与 19±5；p<0.004。嗅觉障碍更严重（失嗅）的患者年龄更大（p=0.001）、体重明显更轻，分别为 75 与 83kg，p=0.01。各组间吸烟者比例、用药情况、吞咽困难或热量摄入无差异。体重减轻者和严重嗅觉丧失与更严重的 H&Y 分期相关。UPSIT 中位数以下（失嗅）的患者在过去几年体重减轻，而 UPSIT 中位数以上（嗅觉减退）的患者体重增加。回归分析显示，UPSIT 中位数水平是体重减轻的最显著变量（p<0.001）。嗅觉随疾病严重程度逐渐丧失。嗅觉丧失程度越高，发生运动障碍的风险越高。
早期评估嗅觉可识别不同表型的患者，了解其体重变化和疾病过程中发生运动障碍的风险。
