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
City Clinical No.1, Novosibirsk, Russia.
Siberian State Medical University, Tomsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(8):56-64. doi: 10.17116/jnevro202212208156.
To study a role of vitamin D and other indicators of calcium-phosphorus metabolism as possible predictors of Parkinson's disease (PD).
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.
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.
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.
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。
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。
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。
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。