Sharma Jagdish C, Vassallo Michael
Lincoln County Hospital & University of Nottingham, LN2 5QY, UK.
Neurodegener Dis Manag. 2014;4(4):309-16. doi: 10.2217/nmt.14.25.
Neurodegenerative Parkinson's disease (PD) is associated with a changing profile of weight as the disease advances. Whilst some patients gain weight, a significant proportion of patients lose weight. PD patients have a lower body weight as compared with non-PD controls. Weight loss is not a benign phenomenon. Patients with lower initial body weight and weight losers have a higher risk of developing dyskinesia. There is a relationship between body weight and levodopa dose, patients with higher levodopa dose per kilogram are at a higher risk of dyskinesia, the risk escalates above 6 mg per kilogram. Lower weight patients have risk of undernutrition and the associated disease pathology due to frailty. Weight losers are at risk of higher mortality and poor quality of life. PD patients should be assessed for body weight and the dose of levodopa be adjusted according to periodic weight changes, supplemented by other dopaminergic medications. Patients at risk of weight loss may be identified by their severe loss of olfaction since there seems to exist the olfaction-weight-dyskinesia phenotype. Measures should be taken to prevent weight loss in at-risk patients to prevent low-weight-related adverse outcomes in PD patients. These measures may protect PD patients from motor and non-motor adverse effects as the disease advances.
神经退行性帕金森病（PD）随着疾病进展，体重变化情况也在改变。虽然一些患者体重增加，但相当一部分患者体重减轻。与非PD对照相比，PD患者体重较低。体重减轻并非良性现象。初始体重较低的患者和体重减轻者发生运动障碍的风险更高。体重与左旋多巴剂量之间存在关联，每公斤体重左旋多巴剂量较高的患者发生运动障碍的风险更高，当剂量超过每公斤6毫克时风险会进一步升高。体重较低的患者存在因身体虚弱导致营养不良及相关疾病病理状况的风险。体重减轻者有更高的死亡风险和较差的生活质量。应对PD患者的体重进行评估，并根据体重的定期变化调整左旋多巴剂量，辅以其他多巴胺能药物。体重减轻风险较高的患者可通过严重嗅觉丧失来识别，因为似乎存在嗅觉-体重-运动障碍表型。应采取措施预防有风险患者体重减轻，以防止PD患者出现与体重过低相关的不良后果。随着疾病进展，这些措施可能会保护PD患者免受运动和非运动方面的不良影响。
