Akbar Umer, He Ying, Dai Yunfeng, Hack Nawaz, Malaty Irene, McFarland Nikolaus R, Hess Christopher, Schmidt Peter, Wu Samuel, Okun Michael S
Department of Neurology, Brown University, Providence, Rhode Island, United States of America.
Department of Mathematics, Clarkson University, Potsdam, New York, United States of America.
PLoS One. 2015 May 4;10(5):e0124541. doi: 10.1371/journal.pone.0124541. eCollection 2015.
Weight loss is common in Parkinson's Disease (PD) and sometimes may precede the diagnosis. Weight loss is associated with multiple factors but its impact on health-related quality of life (HRQL) in PD remains unknown. We sought to investigate the factors associated with weight change and to quantify its effect on HRQL.
The National Parkinson Foundation Quality Improvement Initiative (NPF-QII) data was used to analyze PD patients longitudinally between two visits, separated by 12 ± 6 months. Multiple linear regression analyses were used to assess the associations between baseline covariates and body weight change per month, and to evaluate whether, and to what degree, Parkinson's Disease Questionnaire (PDQ-39) scores were affected.
A higher Hoehn & Yahr stage, higher number of comorbidities, older age, lower MOCA estimate, and higher rate of levodopa usage were observed in patients who lost weight. Multivariate regression analysis indicated that age and levodopa usage were significantly associated with weight loss. Furthermore, monthly body weight loss was significantly associated with HRQL decline in PD patients. Loss of 1 lb (0.45 kg) per month was associated with a decline in QOL: an increase of 0.5% in PDQ-39 Summary Index score (p=0.004), and 1.1% and 1.5% increases in the mobility and ADL dimensions, respectively.
Weight loss in PD is common and seems to correlate with worsened HRQL. Awareness of factors associated with weight loss and its relation to HRQL may help practitioners improve patient management and expectations.
体重减轻在帕金森病（PD）中很常见，有时可能在诊断之前就出现。体重减轻与多种因素相关，但其对PD患者健康相关生活质量（HRQL）的影响尚不清楚。我们旨在研究与体重变化相关的因素，并量化其对HRQL的影响。
使用国家帕金森基金会质量改进计划（NPF-QII）的数据对PD患者进行纵向分析，两次就诊间隔12±6个月。采用多元线性回归分析评估基线协变量与每月体重变化之间的关联，并评估帕金森病问卷（PDQ-39）评分是否受到影响以及受影响的程度。
体重减轻的患者Hoehn&Yahr分期更高、合并症数量更多、年龄更大、蒙特利尔认知评估量表（MOCA）评分更低以及左旋多巴使用率更高。多变量回归分析表明，年龄和左旋多巴使用与体重减轻显著相关。此外，PD患者每月体重减轻与HRQL下降显著相关。每月体重减轻1磅（0.45千克）与生活质量下降相关：PDQ-39综合指数评分增加0.5%（p=0.004），运动和日常生活活动维度分别增加1.1%和1.5%。
PD患者体重减轻很常见，并似乎与HRQL恶化相关。了解与体重减轻相关的因素及其与HRQL的关系可能有助于医生改善患者管理和预期。
