Tassorelli Cristina, Berlangieri Mariangela, Buscone Simona, Bolla Monica, De Icco Roberto, Baricich Alessio, Pacchetti Claudio, Cisari Carlo, Sandrini Giorgio
a Neurological Rehabilitation Unit , IRCCS National Neurological Institute "C. Mondino" Foundation , Pavia , Italy.
b Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy.
Int J Neurosci. 2017 Apr;127(4):299-304. doi: 10.1080/00207454.2016.1206897. Epub 2016 Jul 20.
Evidence suggests that falls and associated bone fractures are more frequent in patients suffering from Parkinson's disease (PD) than in the general population. In this cross-sectional study we evaluated the clinical and biochemical characteristics that are associated to falls, fractures and bone health in a population of PD subjects.
Forty-two consecutive subjects suffering from idiopathic PD (mild-to-moderate severity) with/without falls in the previous year were included. They were characterized as regards functional independence, balance, fear of falling, bone density (ultrasound densitometry) and plasma levels of vitamin D. Twenty-one age- and sex-matched healthy subjects were evaluated as controls.
We detected a greater degree of osteoporosis in PD subjects as compared to controls, more pronounced in males than in females (Z-score: M -3.8 ± 1.6, F -2.28 ± 0.92, p = 0.0006). A positive correlation was found between independence levels and bone density or vitamin D levels. Twenty seven patients (64%) reported falls in the previous year. These were associated to post-traumatic fractures in 16 subjects (59% of fallers). Women fell more than men (fallers: 20 F/7 M; non fallers: 4 F/11 M, χ² test p = 0.02), although the occurrence of post-traumatic fractures among fallers did not differ between sexes (F 11/9, M 5/2, χ² test p > 0.05). Fallers with post-traumatic fractures showed higher degrees of motor impairment.
These findings confirm that falls and osteoporosis represent major health issues in PD, already in the middle stages of disease.
有证据表明，帕金森病（PD）患者比普通人群更易发生跌倒及相关骨折。在这项横断面研究中，我们评估了PD患者人群中与跌倒、骨折及骨骼健康相关的临床和生化特征。
纳入42例连续的特发性PD患者（轻度至中度严重程度），这些患者在上一年有或没有跌倒史。对他们进行功能独立性、平衡能力、跌倒恐惧、骨密度（超声骨密度测定）及血浆维生素D水平等方面的评估。21例年龄和性别匹配的健康受试者作为对照进行评估。
与对照组相比，我们发现PD患者的骨质疏松程度更高，男性比女性更明显（Z值：男性-3.8±1.6，女性-2.28±0.92，p = 0.0006）。发现独立性水平与骨密度或维生素D水平之间存在正相关。27例患者（64%）报告在上一年有跌倒。其中16例（59%的跌倒者）发生了创伤后骨折。女性跌倒的次数多于男性（跌倒者：20例女性/7例男性；未跌倒者：4例女性/11例男性，χ²检验p = 0.02），尽管跌倒者中创伤后骨折的发生率在性别之间没有差异（女性11/9，男性5/2，χ²检验p>0.05）。有创伤后骨折的跌倒者表现出更高程度的运动障碍。
这些发现证实，跌倒和骨质疏松是PD患者主要的健康问题，在疾病的中期阶段就已存在。
