Can Nimet U, Alagöz Aybala N
Clin Lab. 2020 Aug 1;66(8). doi: 10.7754/Clin.Lab.2019.190615.
Idiopathic Parkinson's disease (IPD) is the most common age-related neurodegenerative movement disorder. It causes a decrease and deceleration in movements. It may also lead to loss of bone mineral density, vi-tamin D deficiency, falls and fractures due to various factors. As indicated in our study, determining the prevalence of osteopenia and osteoporosis in IPD is important to determine complications.
Thirty patients with IPD and 30 age-matched control subjects were included in the study. The bone mineral density (BMD) measurements of the participants were taken from the lumbar spine (L1-4) and double femur regions using the dual energy X-ray absorptiometry device. Serum 25 (OH) vitamin D, alkaline phosphatase, parathormone, osteocalcin, prolidase and urine hydroxyproline levels were measured.
The femur total BMD and serum 25 (OH) vitamin D levels were lower in the patients with IPD than in the control group (p > 0.05). The serum prolidase and urinary hydroxyproline levels were higher in the IPD group relative to the control group (p < 0.05). The frequency of osteoporosis and osteopenia was significantly higher in the IPD group than in the control group (p < 0.05).
Patients with Parkinson's disease tend to have lower vitamin D levels than those with a similar age without Parkinson's disease. Vitamin D levels are usually associated with BMD in people with Parkinson's disease, but administering vitamin D does not improve BMD. Cross-sectional studies suggest a correlation between vitamin D levels and the severity of symptoms of Parkinson's disease. Decreased exposure to sunlight due to immobilisation and reduced vitamin D intake by diet may lead to vitamin D deficiency and low BMD. There is a negative correlation among the duration of disease, disease severity, number of falls, parathormone level and serum vitamin D level in people with Parkinson's disease. Consequently, vitamin D levels may be low in Parkinson's disease patients. Therefore, patients with Parkinson's disease should be checked for vitamin D and osteoporosis by considering the risk of hip fracture, fall from a height and high risk of osteoporosis.
特发性帕金森病（IPD）是最常见的与年龄相关的神经退行性运动障碍。它会导致运动减少和运动迟缓。由于各种因素，它还可能导致骨矿物质密度降低、维生素D缺乏、跌倒和骨折。如我们的研究所示，确定IPD中骨质减少和骨质疏松的患病率对于确定并发症很重要。
本研究纳入了30例IPD患者和30例年龄匹配的对照受试者。使用双能X线吸收测定仪对参与者的骨矿物质密度（BMD）进行测量，测量部位为腰椎（L1 - 4）和双侧股骨区域。检测血清25（OH）维生素D、碱性磷酸酶、甲状旁腺激素、骨钙素、脯氨酰肽酶和尿羟脯氨酸水平。
IPD患者的股骨总BMD和血清25（OH）维生素D水平低于对照组（p > 0.05）。IPD组的血清脯氨酰肽酶和尿羟脯氨酸水平高于对照组（p < 0.05）。IPD组骨质疏松和骨质减少的发生率显著高于对照组（p < 0.05）。
帕金森病患者的维生素D水平往往低于同龄非帕金森病患者。在帕金森病患者中，维生素D水平通常与BMD相关，但补充维生素D并不能改善BMD。横断面研究表明维生素D水平与帕金森病症状的严重程度之间存在相关性。由于活动受限导致日照减少以及饮食中维生素D摄入量降低可能导致维生素D缺乏和低BMD。帕金森病患者的病程、疾病严重程度、跌倒次数、甲状旁腺激素水平和血清维生素D水平之间存在负相关。因此，帕金森病患者的维生素D水平可能较低。因此，应考虑帕金森病患者髋部骨折、高处坠落风险以及骨质疏松高风险，对其进行维生素D和骨质疏松检查。
