Ling Q J, Cheng X Y, Chen M L, Zhang R, Mao C J, Liu C F
Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2023 Sep 19;103(35):2765-2771. doi: 10.3760/cma.j.cn112137-20230413-00609.
To investigate the relationship between nutritional status, body composition and symptoms of Parkinson's disease (PD). The study was conducted among 102 PD patients between November 2020 to April 2021 in the outpatient and inpatient of Neurology department of the Second Affiliated Hospital of Suzhou University. Basic data, such as age, gender, course of disease and Hoehn-Yahr (H-Y) stage of the patients, were collected. In the "open" state, the Unified Parkinson's Disease Rating Scale (UPDRS) and other scales were used to evaluate the clinical symptoms of PD patients. The nutritional status of PD patients was evaluated by the micro-nutrition rating Scale (MNA), and the body composition data of PD patients was measured by the body composition analyzer.The patients were divided into three groups according to the MNA: well-nourished group(45 cases), malnutrition-risk group (43 cases)and malnutrition group(14 cases). Body composition, laboratory tests, bone density, and symptoms of PD were compared among the three groups. Among 102 PD patients, 48 were males (47.1%) and 54 were females (52.9%), aged 42-86 (66±9) years old. Compared with the malnutrition-risk group, lymphocytes in the malnutrition group [(1.45±0.48) × 10/L vs (1.76±0.43)×10/L], uric acid [(227±54) μmol/L vs (282±63) μmol/L] were all low, and the difference was statistically significant (all <0.05). Compared with the well-nourished group, hemoglobin [(125±17) g/L vs (136±14) g/L], prealbumin [(0.23±0.05) g/L vs (0.27±0.06) g/L], and uric acid [(227±54) μmol/L vs (312±76) μmol/L] and Retinol binding protein [(33±7) mg/L were lower than (39±10) mg/L] in the malnutrition group, the difference was statistically significant (<0.05). Except for the visceral fat area and body fat percentages, there was no significant difference in body composition indexes and bone mineral density T-value between the malnutrition-risk and malnutrition groups (<0.05). Compared with the well-nourished group, the body fat [(16±6) kg vs (20±6) kg], the percentage of body fat [(26±9)% vs (29±7)%], the waist-hip ratio [(0.86±0.05) vs (0.89±0.05)], and the upper arm circumference [(29.00±2.59) cm vs (30.74±2.75) cm] in the malnutrition risk group were lower, and the difference was statistically significant (<0.05). There were statistically significant differences in all body composition indicators and T-values of bone density between the malnourished and well nourished groups (all <0.05). The MNA score of PD patients was negatively correlated with UPDRS Ⅰ, UPDRS Ⅱ, and UPDRS Ⅳ scores (=-0.347, -0.364, -0.303, all <0.05); Body composition indicators: total body water and inorganic salts were negatively correlated with UPDRS-I (=-0.206, -0.223, all <0.05), and body fat was negatively correlated with levodopa Equivalent dose (LED) (=-0.209, <0.05) The malnutrition risk and incidence of malnutrition in PD patients are high; lymphocyte, uric acid, hemoglobin, Retinol binding protein, body composition and bone mineral density were low in malnutrition group. MNA score of PD patients was negatively correlated with Parkinson's disease symptoms.
探讨帕金森病(PD)患者营养状况、身体成分与症状之间的关系。本研究于2020年11月至2021年4月在苏州大学附属第二医院神经内科门诊及住院部对102例PD患者进行。收集患者的年龄、性别、病程、Hoehn-Yahr(H-Y)分期等基础数据。在“开”状态下,使用统一帕金森病评定量表(UPDRS)等量表评估PD患者的临床症状。采用微型营养评定量表(MNA)评估PD患者的营养状况,使用人体成分分析仪测量PD患者的身体成分数据。根据MNA将患者分为三组:营养良好组(45例)、营养不良风险组(43例)和营养不良组(14例)。比较三组患者的身体成分、实验室检查、骨密度及PD症状。102例PD患者中,男性48例(47.1%),女性54例(52.9%),年龄42 - 86(66±9)岁。与营养不良风险组相比,营养不良组的淋巴细胞[(1.45±0.48)×10⁹/L vs(1.76±0.43)×10⁹/L]、尿酸[(227±54)μmol/L vs(282±63)μmol/L]均较低,差异有统计学意义(均<0.05)。与营养良好组相比,营养不良组的血红蛋白[(125±17)g/L vs(136±14)g/L]、前白蛋白[(0.23±0.05)g/L vs(0.27±0.06)g/L]、尿酸[(227±54)μmol/L vs(312±76)μmol/L]及视黄醇结合蛋白[(33±7)mg/L低于(39±10)mg/L]均较低,差异有统计学意义(<0.05)。除内脏脂肪面积和体脂百分比外,营养不良风险组与营养不良组的身体成分指标及骨密度T值差异无统计学意义(<0.05)。与营养良好组相比,营养不良风险组的体脂[(16±6)kg vs(20±6)kg]、体脂百分比[(26±9)% vs(29±7)%]、腰臀比[(0.86±0.05)vs(0.89±0.05)]及上臂围[(29.00±2.59)cm vs(30.74±2.75)cm]较低,差异有统计学意义(<0.05)。营养不良组与营养良好组在所有身体成分指标及骨密度T值上差异均有统计学意义(均<0.05)。PD患者的MNA评分与UPDRSⅠ、UPDRSⅡ及UPDRSⅣ评分呈负相关(r = -0.347,-0.364,-0.303,均<0.05);身体成分指标:全身水和无机盐与UPDRS -Ⅰ呈负相关(r = -0.206,-0.223,均<0.05),体脂与左旋多巴等效剂量(LED)呈负相关(r = -0.209,<0.05)。PD患者营养不良风险及营养不良发生率较高;营养不良组淋巴细胞、尿酸、血红蛋白、视黄醇结合蛋白、身体成分及骨密度较低。PD患者的MNA评分与帕金森病症状呈负相关。