Ghourchian Shadi, Gruber-Baldini Ann L, Shakya Sunita, Herndon John, Reich Stephen G, von Coelln Rainer, Savitt Joseph M, Shulman Lisa M
Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Parkinsonism Relat Disord. 2021 Feb;83:31-36. doi: 10.1016/j.parkreldis.2020.12.018. Epub 2021 Jan 12.
Parkinson disease (PD) has been associated with both weight loss and gain in different stages of the disease. Our study aimed to determine the prevalence and associations with weight change over two years based on 3% and 5% weight change.
In this longitudinal analysis, weight at baseline and follow-up was used to classify patients into groups of weight loss, stable, and weight gain. Differences between these groups at baseline and then with change over time were tested.
The sample was 668 patients with mean(SD) age 66.1(10) and disease duration 5.3(5.4) years. Using 3% weight change criteria: 32.6% lost, 23.1% gained, and 55.7% had stable weight. Using 5% criteria: 22.6% lost, 15.7% gained, and 61.7% had stable weight. Age was associated with both 3% and 5% change in weight. Other associations with 5% weight change were disease duration, Total and Motor Unified Parkinson's Disease Rating Scale, Older Americans Resource and Services disability, and Hoehn & Yahr staging. The effects of 3% weight loss on Motor UPDRS, IADLs, and depression, and the effects of 5% weight loss on IADLs remained statistically significant when controlling for baseline differences in age, levodopa use, and Total UPDRS.
PD patients are more likely to experience 3% than 5% weight change and this lower threshold of weight change was associated with greater disease severity and disability over time. Attention to more subtle weight change may help identify those at greater risk of disability.
帕金森病(PD)在疾病的不同阶段与体重减轻和体重增加均有关联。我们的研究旨在根据3%和5%的体重变化确定两年内体重变化的患病率及其相关因素。
在这项纵向分析中,使用基线和随访时的体重将患者分为体重减轻组、体重稳定组和体重增加组。对这些组在基线时以及随时间变化的差异进行了检验。
样本为668例患者,平均(标准差)年龄66.1(10)岁,病程5.3(5.4)年。采用3%体重变化标准:32.6%体重减轻,23.1%体重增加,55.7%体重稳定。采用5%标准:22.6%体重减轻,15.7%体重增加,61.7%体重稳定。年龄与3%和5%的体重变化均有关联。与5%体重变化相关的其他因素包括病程、帕金森病统一评分量表总分及运动分、美国老年人资源与服务残疾评定以及霍恩和雅尔分期。在控制年龄、左旋多巴使用情况和统一帕金森病评分量表总分的基线差异后,3%体重减轻对运动性统一帕金森病评分量表、工具性日常生活活动能力及抑郁的影响,以及5%体重减轻对工具性日常生活活动能力的影响仍具有统计学意义。
帕金森病患者体重变化达到3%的可能性大于5%,这种较低的体重变化阈值与疾病严重程度增加及随时间推移的残疾有关。关注更细微的体重变化可能有助于识别残疾风险更高的患者。