Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Y.B. Training and Research Hospital, Ankara, Turkey.
Department of Physical Medicine and Rehabilitation, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey.
Neurol India. 2020 Mar-Apr;68(2):394-400. doi: 10.4103/0028-3886.283755.
Although it is well known that patients with Parkinson's disease (PD) have low bone mineral density (BMD) and serum vitamin D level, there are no studies evaluating their relationship with the stage and clinical features of the PD.
The purpose of this study was to evaluate the relationship between BMD and serum vitamin D level and stage or clinical features of the PD.
One hundred twenty-four patients with PD recruited from Movement Disorders Outpatient Clinic and age- and sex-matched 116 healthy controls were included in the study. BMD and serum vitamin D level of all participants were measured. After patients had been divided into four groups according to Hoehn and Yahr (H and Y) staging, a total of 5 groups with controls, BMD (lumbar and femoral) and serum vitamin D level were compared between groups. The relationship between the clinical features of the PD [disease duration, medication history, Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and subscores of UPDRS part III] and BMD or vitamin D was investigated.
Lumbar and femoral BMD values and serum vitamin D level were significantly lower in patients with PD compared to controls. Low BMD and low serum vitamin D level were identified in the early stages of the disease (H and Y stage 1 and 1.5) and were marked by the progress of the stage of the disease. There was a negative relationship between the clinical features of the PD and both BMD and serum vitamin D level.
All patients with PD should be screened for developing osteoporosis and for sufficient vitamin D level in the early stages of the disease. Preventive methods for bone quality should be taken into consideration at the onset of PD.
尽管众所周知，帕金森病（PD）患者的骨密度（BMD）和血清维生素 D 水平较低，但尚无研究评估其与 PD 分期和临床特征的关系。
本研究旨在评估 BMD 和血清维生素 D 水平与 PD 分期或临床特征的关系。
从运动障碍门诊招募了 124 名 PD 患者和 116 名年龄和性别匹配的健康对照者纳入本研究。测量所有参与者的 BMD 和血清维生素 D 水平。根据 Hoehn 和 Yahr（H 和 Y）分期将患者分为四组后，共比较了五组对照者、BMD（腰椎和股骨）和血清维生素 D 水平。研究了 PD 的临床特征[病程、用药史、统一帕金森病评定量表（UPDRS）第二部分和第三部分以及 UPDRS 第三部分的子评分]与 BMD 或维生素 D 的关系。
与对照组相比，PD 患者的腰椎和股骨 BMD 值和血清维生素 D 水平明显较低。在疾病的早期（H 和 Y 分期 1 和 1.5）就发现了低 BMD 和低血清维生素 D 水平，且随着疾病分期的进展而明显。PD 的临床特征与 BMD 和血清维生素 D 水平均呈负相关。
所有 PD 患者都应在疾病早期筛查是否发生骨质疏松症和是否有足够的维生素 D 水平。应在 PD 发病时考虑采取改善骨质量的预防措施。
