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[维生素D及钙磷代谢的其他指标作为帕金森病的潜在预测指标]

[Vitamin D and other indicators of calcium-phosphorus metabolism as possible predictors of Parkinson's disease].

作者信息

Novotnij D A, Zhukova N G, Shperling L P, Stolyarova V A, Zhukova I A, Agasheva A E, Shtaimets S V, Druzhinina O A, Shirokikh I V

机构信息

City Clinical No.1, Novosibirsk, Russia.

Siberian State Medical University, Tomsk, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(8):56-64. doi: 10.17116/jnevro202212208156.

Abstract

OBJECTIVE

To study a role of vitamin D and other indicators of calcium-phosphorus metabolism as possible predictors of Parkinson's disease (PD).

MATERIAL AND METHODS

The main group consisted of 138 patients with PD, the control group included 79 patients without PD. Serum levels of 25-hydroxyvitamin D (25[OH]D) were determined by chemo-luminescence immunoassay. Additionally, the following biochemical markers were evaluated: parathyroid hormone, calcitonin, thyroid-stimulating hormone, thyroxine, alkaline phosphatase, inorganic phosphorus, total calcium, ionized calcium, total protein. In addition, densitometry of the spine (1-4 lumbar vertebrae), proximal femurs, and the middle third of the radius was performed. The relationship between the level of vitamin D in blood serum and clinical data was evaluated using correlation analysis.

RESULTS

Regression analysis revealed a statistically significant contribution of the levels of parathyroid hormone, vitamin D, alkaline phosphatase and the T-value of the bone density of the neck of the right hip (T-score NRH) to the probability of PD. In the main group, bone mineral density was significantly different between the groups (=0.028). Also, there was a high incidence of osteopenia (64%) and osteoporosis (73%). Based on the obtained regression equation, the probability of having PD is =1/(1+exp), where «x» is the parathyroid hormone level, «y» is T-score NRH, «z» is the vitamin D level, «k» is the activity of alkaline phosphatase, exp is the exponent.

CONCLUSION

Vitamin D levels, alkaline phosphatase activity, and T-score NRH have a statistically significant effect on the likelihood of developing PD. With a decrease in the above indicators relative to normal values, the likelihood of having PD increases.

摘要

目的

研究维生素D及其他钙磷代谢指标作为帕金森病(PD)潜在预测指标的作用。

材料与方法

主要研究组由138例PD患者组成,对照组包括79例非PD患者。采用化学发光免疫分析法测定血清25-羟基维生素D(25[OH]D)水平。此外,还评估了以下生化指标:甲状旁腺激素、降钙素、促甲状腺激素、甲状腺素、碱性磷酸酶、无机磷、总钙、离子钙、总蛋白。另外,对脊柱(第1 - 4腰椎)、股骨近端和桡骨中1/3进行骨密度测定。采用相关性分析评估血清维生素D水平与临床数据之间的关系。

结果

回归分析显示,甲状旁腺激素水平、维生素D、碱性磷酸酶水平及右髋部颈骨密度T值(T-score NRH)对PD发病概率有统计学意义上的显著影响。在主要研究组中,两组间骨矿物质密度存在显著差异(P = 0.028)。此外,骨量减少(64%)和骨质疏松(73%)的发生率较高。根据所得回归方程,患PD的概率为P = 1/(1 + exp),其中“x”为甲状旁腺激素水平,“y”为T-score NRH,“z”为维生素D水平,“k”为碱性磷酸酶活性,exp为指数。

结论

维生素D水平、碱性磷酸酶活性和T-score NRH对发生PD的可能性有统计学意义上的显著影响。上述指标相对于正常值降低时,患PD的可能性增加。

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