Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China.
BMC Geriatr. 2023 Aug 16;23(1):494. doi: 10.1186/s12877-023-04188-3.
Sarcopenia is commonly seen in the older adults and increases in incidence with age, also in Parkinson's disease (PD). Although research has indicated that the development of sarcopenia in patients with PD may be related to both motor symptoms and non-motor symptoms (NMS), the precise relationship between the two conditions remains unclear. Therefore, we aimed to investigate the incidence of sarcopenia in patients with PD and its association with NMS.
The study included 123 patients with PD and 38 age- and sex-matched healthy controls (HC). All participants were evaluated for sarcopenia using the 2019 Asian Sarcopenia Diagnostic Criteria, and patients with PD underwent standard assessments of motor symptoms and NMS. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were used to examine the association between sarcopenia and NMS in patients with PD.
The incidence of sarcopenia was significantly higher in patients with PD than in HC (26.8% vs. 10.4%, p = 0.046). Multiple logistic regression analysis revealed that poorer sleep quality (odds ratio [OR]: 1.245; 95% confidence interval [CI]: 1.011-1.533; p = 0.040) and fatigue (OR: 1.085, 95% CI: 1.006-1.170, p = 0.034) were independently associated with sarcopenia. ROC analysis indicated that the optimal cut-off value for Pittsburgh Sleep Quality Index (PSQI) scores was 10, with 72.7% sensitivity and 74.4% specificity (area under the curve [AUC] = 0.776, 95% CI: 0.683-0.868, p < 0.001). The optimal cut-off value for Fatigue Severity Scale (FSS) scores was 39, with 87% sensitivity and 50% specificity (AUC = 0.725, 95% CI: 0.629 -0.820, p < 0.001). Joint use of FSS and PSQI scores increased the predictive value for sarcopenia(AUC = 0.804, 95% CI: 0.724-0.885, p < 0.001).
Patients with PD are more susceptible to sarcopenia than healthy older adults, and fatigue and poorer sleep are positively associated with sarcopenia. Further longitudinal studies are needed to clarify the causal relationships.
肌少症在老年人中较为常见,且随年龄增长发病率升高,在帕金森病(PD)中也如此。虽然研究表明 PD 患者肌少症的发展可能与运动症状和非运动症状(NMS)有关,但两者之间的确切关系尚不清楚。因此,我们旨在研究 PD 患者肌少症的发生率及其与 NMS 的关系。
本研究纳入了 123 例 PD 患者和 38 名年龄和性别匹配的健康对照者(HC)。所有参与者均采用 2019 年亚洲肌少症诊断标准进行肌少症评估,PD 患者接受了运动症状和 NMS 的标准评估。采用多因素逻辑回归和受试者工作特征(ROC)曲线分析,探讨 PD 患者肌少症与 NMS 的关系。
PD 患者肌少症的发生率明显高于 HC(26.8%比 10.4%,p=0.046)。多因素逻辑回归分析显示,睡眠质量较差(比值比 [OR]:1.245;95%置信区间 [CI]:1.011-1.533;p=0.040)和疲劳(OR:1.085,95%CI:1.006-1.170,p=0.034)与肌少症独立相关。ROC 分析表明,匹兹堡睡眠质量指数(PSQI)评分的最佳截断值为 10,灵敏度为 72.7%,特异性为 74.4%(曲线下面积 [AUC]:0.776,95%CI:0.683-0.868,p<0.001)。疲劳严重程度量表(FSS)评分的最佳截断值为 39,灵敏度为 87%,特异性为 50%(AUC:0.725,95%CI:0.629-0.820,p<0.001)。联合使用 FSS 和 PSQI 评分可提高肌少症的预测价值(AUC:0.804,95%CI:0.724-0.885,p<0.001)。
PD 患者比健康老年人更容易发生肌少症,且疲劳和睡眠质量较差与肌少症呈正相关。需要进一步的纵向研究来阐明因果关系。