Louis E D, Michalec M
GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Eur J Neurol. 2015 Feb;22(2):384-8. doi: 10.1111/ene.12589. Epub 2014 Nov 4.
There is mounting evidence that essential tremor (ET) is a neurodegenerative disease. Reduced body mass index (BMI) is a clinical feature of many neurodegenerative diseases, yet there has been little documentation of BMI in patients with ET.
Essential tremor cases and controls were enrolled in a study of the environmental epidemiology of ET at Columbia University Medical Center. Weight and height were measured using a standard protocol; BMI was weight (kg) divided by height (m(2)). Daily calorie count (kcal) was calculated using the Willett Semi-Quantitative Food Frequency Questionnaire. Tremor severity was assessed with a clinical rating scale (total tremor score, range 0-36).
The 382 ET cases and 392 controls were similar with respect to age, gender and other demographic variables. BMI was lower in ET cases than controls [26.7 ± 5.0 (median = 26.2) vs. 27.7 ± 5.6 (median = 26.7), P = 0.03] despite the fact that the daily caloric intake was marginally higher in ET cases than controls (P = 0.09). In ET cases, BMI was not associated with tremor severity (Spearman's r = -0.02, P = 0.66) but, among younger onset ET cases, longer tremor duration was associated with lower BMI (Spearman's r = -0.14, P = 0.049).
The observed lower BMI in ET is consistent with the neurodegenerative hypothesis of ET. The data also suggest that some mechanism other than decreased daily caloric intake or an involuntary movement-related increased burning of calories is likely to account for this case-control difference.
越来越多的证据表明，特发性震颤（ET）是一种神经退行性疾病。体重指数（BMI）降低是许多神经退行性疾病的临床特征，但关于ET患者BMI的文献报道较少。
在哥伦比亚大学医学中心，特发性震颤病例和对照被纳入一项ET环境流行病学研究。采用标准方案测量体重和身高；BMI为体重（千克）除以身高（米的平方）。使用威尔特半定量食物频率问卷计算每日卡路里摄入量（千卡）。用临床评分量表评估震颤严重程度（总震颤评分，范围0 - 36）。
382例ET病例和392例对照在年龄、性别和其他人口统计学变量方面相似。尽管ET病例的每日热量摄入量略高于对照（P = 0.09），但ET病例的BMI低于对照[26.7±5.0（中位数 = 26.2）对27.7±5.6（中位数 = 26.7），P = 0.03]。在ET病例中，BMI与震颤严重程度无关（斯皮尔曼相关系数r = -0.02，P = 0.66），但在发病年龄较轻的ET病例中，震颤持续时间较长与较低的BMI相关（斯皮尔曼相关系数r = -0.14，P = 0.049）。
ET患者中观察到的较低BMI与ET神经退行性假说一致。数据还表明，除了每日热量摄入减少或与非自主运动相关的热量消耗增加之外，可能还有其他机制导致这种病例对照差异。
