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维生素 D 在早期帕金森病疾病进展中的作用。

The Role of Vitamin D in Disease Progression in Early Parkinson's Disease.

机构信息

Clinical Ageing Research Unit, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.

Bone Clinic, Freeman Hospital, Freeman Road, Newcastle upon Tyne, UK.

出版信息

J Parkinsons Dis. 2017;7(4):669-675. doi: 10.3233/JPD-171122.

Abstract

BACKGROUND

Previous cross-sectional studies have shown that Parkinson's disease (PD) patients have lower serum 25-hydroxy vitamin D (25(OH)D) concentrations than controls. Vitamin D deficiency was associated with increased disease severity and cognitive impairment in prevalent PD patients.

OBJECTIVE

The aim of the study was to determine 25(OH)D in newly diagnosed PD and age-matched controls and to assess if there was an association with clinical outcomes (disease severity, cognition and falls) over the 36-month follow up period.

METHODS

A prospective observational study of newly diagnosed PD patients in the North East of England with age-matched controls (PD, n = 145; control, n = 94). Serum 25(OH)D was assessed at baseline and 18 months. Participants underwent clinical assessment at baseline, 18 and 36 months. One hundred and ten participants with PD also took part in a prospective falls study.

RESULTS

Mean serum 25(OH)D concentrations were lower in PD than control participants at baseline (44.1±21.7 vs. 52.2±22.1 nmol/L, p < 0.05) and 18 months (44.2±23.6 vs. 55.7±28.8 nmol/L, p < 0.05). Baseline serum 25(OH)D concentration, age, motor score and dosage of dopaminergic medication were significant predictors of variance of motor severity at 36 months ((ΔR2 = 0.039, F = 6.6, p < 0.01). Serum 25(OH)D was not associated with cognition or falls during the follow up period.

CONCLUSIONS

Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, which may have implications in terms of bone health and fracture risk. There was a small but significant association between vitamin D status at baseline and disease motor severity at 36 months.

摘要

背景

先前的横断面研究表明,帕金森病(PD)患者的血清 25-羟维生素 D(25(OH)D)浓度低于对照组。维生素 D 缺乏与现患 PD 患者的疾病严重程度和认知障碍增加有关。

目的

本研究旨在确定新诊断的 PD 患者和年龄匹配的对照组中的 25(OH)D,并评估其在 36 个月随访期间与临床结局(疾病严重程度、认知和跌倒)的相关性。

方法

一项在英格兰东北部进行的新诊断 PD 患者的前瞻性观察性研究,纳入了年龄匹配的对照组(PD 组,n=145;对照组,n=94)。在基线和 18 个月时评估血清 25(OH)D。参与者在基线、18 个月和 36 个月时接受临床评估。110 名 PD 患者还参加了一项前瞻性跌倒研究。

结果

PD 组患者的血清 25(OH)D 浓度在基线时(44.1±21.7 与 52.2±22.1 nmol/L,p<0.05)和 18 个月时(44.2±23.6 与 55.7±28.8 nmol/L,p<0.05)均低于对照组。基线血清 25(OH)D 浓度、年龄、运动评分和多巴胺能药物剂量是 36 个月时运动严重程度变异的显著预测因素(ΔR2=0.039,F=6.6,p<0.01)。在随访期间,血清 25(OH)D 与认知或跌倒无关。

结论

新发 PD 患者的血清 25(OH)D 浓度明显低于年龄匹配的对照组,这可能对骨骼健康和骨折风险产生影响。基线时维生素 D 状态与 36 个月时疾病运动严重程度之间存在较小但显著的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5e5/5676984/36dd4ac77dcd/jpd-7-jpd171122-g001.jpg

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