Department of Geriatrics, Fondazione Poliambulanza, Brescia, Italy.
Department of Geriatrics, Centro di Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore di Roma and IRCCS Fondazione Policlinico "A. Gemelli", Rome, Italy.
Aging Clin Exp Res. 2020 Jan;32(1):77-84. doi: 10.1007/s40520-019-01166-x. Epub 2019 Mar 15.
Parkinson's disease (PD) is responsible for significant changes in body composition.
We aimed to test the association between PD severity and fat distribution patterns, and to investigate the potential modifier effect of nutritional status in this association.
We enrolled 195 PD subjects consecutively admitted to a university geriatric day hospital. All participants underwent comprehensive clinical evaluation, including assessment of total and regional body composition (dual-energy X-ray absorptiometry, DXA), body mass index, nutritional status (Mini-Nutritional Assessment, MNA), motor disease severity (UPDRS III), comorbidities, and pharmacotherapy.
The fully adjusted linear regression model showed a negative association between UPDRS III and total body fat in kg and percentage (respectively, B - 0.79; 95% CI - 1.54 to - 0.05 and B - 0.55; 95% CI - 1.04 to - 0.05), percentage android fat (B - 1.07; 95% CI - 1.75 to - 0.39), trunk-leg fat ratio (B - 0.02; 95% CI - 0.04 to - 0.01), trunk-limb fat ratio (B - 0.01; 95% CI - 0.06 to - 0.01) and android-gynoid fat ratio (B - 0.01; 95% CI - 0.03 to - 0.01). After stratification by MNA score, all the parameters of android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5 (risk of malnutrition or malnutrition).
We found a negative association between severity of motor impairment and total fat mass in PD, more specific with respect to an android pattern of fat distribution. This association seems to be driven by nutritional status, and is significant only among patients at risk of malnutrition or with overt malnutrition.
帕金森病（PD）会导致身体成分发生重大变化。
我们旨在检验 PD 严重程度与脂肪分布模式之间的关联，并探讨营养状况对这种关联的潜在修饰作用。
我们连续招募了 195 名入住大学老年日医院的 PD 患者。所有参与者均接受了全面的临床评估，包括身体总成分和区域成分（双能 X 射线吸收法，DXA）、体重指数、营养状况（迷你营养评估，MNA）、运动疾病严重程度（UPDRS III）、合并症和药物治疗的评估。
完全调整后的线性回归模型显示，UPDRS III 与总身体脂肪量（kg）和百分比（分别为 B -0.79；95%置信区间 -1.54 至 -0.05 和 B -0.55；95%置信区间 -1.04 至 -0.05）、身体脂肪百分比（B -1.07；95%置信区间 -1.75 至 -0.39）、躯干-下肢脂肪比例（B -0.02；95%置信区间 -0.04 至 -0.01）、躯干-肢体脂肪比例（B -0.01；95%置信区间 -0.06 至 -0.01）和内脏型-脂肪型比例（B -0.01；95%置信区间 -0.03 至 -0.01）呈负相关。根据 MNA 评分分层后，所有安卓样脂肪分布参数与 UPDRS III 均呈负相关（p<0.001），但仅在 MNA<23.5（有营养不良或营养风险）的患者中存在。
我们发现 PD 患者运动功能障碍的严重程度与总脂肪量呈负相关，特别是与安卓样脂肪分布模式相关。这种关联似乎是由营养状况驱动的，并且仅在有营养不良或明显营养不良风险的患者中具有统计学意义。
