Song Shengfang, Luo Zhehui, Li Chenxi, Huang Xuemei, Shiroma Eric J, Simonsick Eleanor M, Chen Honglei
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Neurology, Hersey Medical Center, Pennsylvania State University, Hersey, Pennsylvania, USA.
Mov Disord. 2021 Jul;36(7):1617-1623. doi: 10.1002/mds.28536. Epub 2021 Feb 22.
Weight loss is common in Parkinson's disease (PD). However, little is known about when it starts, how PD changes as it progresses, and whether there is a differential loss of lean or fat mass. The objective of this study was to examine how body composition changes before and after PD diagnosis.
In the Health, Aging, and Body Composition study (n = 3075; age range, 70-79 years), body composition was assessed using dual-energy x-ray absorptiometry on an annual or biennial basis from year 1 to year 10. For each PD case each year, we calculated the difference between their actual body composition measures and expected values had they not developed PD. Using linear mixed models with crossed random effects, we further examined the trend of change in body composition measures before and after PD diagnosis.
A total of 80 PD cases were identified in this cohort. Compared with their expected values, PD cases began to lose total and fat mass about 6-7 years before diagnosis, although the differences were not statistically significant until 3-5 years after diagnosis. The loss was substantial and persistent, with statistically significant trends of loss for total body mass (P = 0.008), fat mass (P = 0.001), and percentage fat (P < 0.001). In comparison, lean mass was stable throughout the follow-up (P = 0.16). Overall, 96% of the body mass loss in PD cases was from the loss of fat mass.
In this longitudinal analysis with objective measures of body composition, we found persistent weight loss in PD cases, predominantly in fat mass, starting a few years before diagnosis. © 2021 International Parkinson and Movement Disorder Society.
体重减轻在帕金森病（PD）中很常见。然而，对于体重减轻何时开始、PD在进展过程中如何变化，以及瘦体重或脂肪量是否存在差异丢失，人们知之甚少。本研究的目的是检查PD诊断前后身体成分如何变化。
在健康、衰老和身体成分研究（n = 3075；年龄范围70 - 79岁）中，从第1年到第10年每年或每两年使用双能X线吸收法评估身体成分。对于每年的每个PD病例，我们计算了他们实际的身体成分测量值与未患PD时的预期值之间的差异。使用具有交叉随机效应的线性混合模型，我们进一步研究了PD诊断前后身体成分测量值的变化趋势。
该队列中共识别出80例PD病例。与预期值相比，PD病例在诊断前约6 - 7年开始出现总体重和脂肪量的丢失，尽管直到诊断后3 - 5年差异才具有统计学意义。这种丢失是显著且持续的，总体重（P = 0.008）、脂肪量（P = 0.001）和脂肪百分比（P < 0.001）均有统计学意义的丢失趋势。相比之下，瘦体重在整个随访过程中保持稳定（P = 0.16）。总体而言，PD病例中96%的体重减轻来自脂肪量的丢失。
在这项对身体成分进行客观测量的纵向分析中，我们发现PD病例在诊断前几年就开始持续体重减轻，主要是脂肪量的减少。© 2021国际帕金森和运动障碍协会。
