Kurihara Kanako, Fujioka Shinsuke, Mishima Takayasu, Tsuboi Yoshio
Department of Neurology, Fukuoka University, Fukuoka, Japan.
Front Neurol. 2024 Jan 5;14:1306138. doi: 10.3389/fneur.2023.1306138. eCollection 2023.
Weight loss is one of the non-motor symptoms frequently seen in patients with Parkinson's disease (PwPD). Weight loss in PwPD is known to be negatively associated with motor and other non-motor symptoms and has been shown to influence the prognosis of PD. In this study, we followed weight change over a 4-year period in PwPD at a single institution and investigated the relationship between weight change and patients' motor and non-motor symptoms.
PwPD who visited our hospital from January 2018 to December 2022 were enrolled. Body weights were measured at two points in 2018 (at the start of observation, 'baseline') and 2022 (at the end of observation, 'end date'). In addition, motor symptoms, disease severity, cognitive function, and psychiatric symptoms were evaluated during the same period, and the relationship with weight loss was examined.
Data of 96 PwPD were available for a 4-year follow-up. At baseline, the mean age was 65.7 ± 10.0 years, the mean disease duration was 6.8 ± 4.0 years, and the mean Hoehn and Yahr stage was 2.4 ± 0.7. Among them, 48 patients (50.0%) had a weight loss of ≥5% from baseline (weight loss group; mean loss was 6.6 ± 2.9 kg). The weight loss group was older ( = 0.031), had a lower Mini-Mental State Examination (MMSE) at baseline ( = 0.019), a significantly lower body mass index ( < 0.001), and a higher Zung Self-Rating Depression Scale (SDS) ( = 0.017) at the end date. There was a negative correlation (γ = -0.349, < 0.001) between weight change and age, a positive correlation (γ = 0.308, = 0.002) between weight change and MMSE at baseline, and a negative correlation (γ = -0.353, < 0.001) between weight change and SDS at the end date. Age-adjusted correlations showed a final negative correlation (γ = -0.331, = 0.001) between weight change and SDS. MMSE and age-adjusted correlations showed a low negative correlation (γ = -0.333, = 0.001) between weight change and SDS at the end date.
Weight loss in PwPD in mid-stage was more likely with increasing age, and ≥ 5% weight loss was associated with worsening depression. Further research is needed regarding the significance of weight loss in PwPD.
体重减轻是帕金森病（PwPD）患者常见的非运动症状之一。已知PwPD患者的体重减轻与运动及其他非运动症状呈负相关，并已显示出会影响帕金森病的预后。在本研究中，我们在单一机构对PwPD患者进行了为期4年的体重变化跟踪，并调查了体重变化与患者运动和非运动症状之间的关系。
纳入2018年1月至2022年12月期间到我院就诊的PwPD患者。在2018年（观察开始时，即“基线”）和2022年（观察结束时，即“结束日期”）两个时间点测量体重。此外，在同一时期评估运动症状、疾病严重程度、认知功能和精神症状，并检查与体重减轻的关系。
96例PwPD患者的数据可供进行4年的随访。基线时，平均年龄为65.7±10.0岁，平均病程为6.8±4.0年，平均Hoehn和Yahr分期为2.4±0.7。其中，48例患者（50.0%）体重较基线下降≥5%（体重减轻组；平均减轻6.6±2.9kg）。体重减轻组年龄较大（P=0.031），基线时简易精神状态检查表（MMSE）得分较低（P=0.019），体重指数显著较低（P<0.001），在结束日期时zung自评抑郁量表（SDS）得分较高（P=0.017）。体重变化与年龄之间存在负相关（γ=-0.349，P<0.001），体重变化与基线时的MMSE之间存在正相关（γ=0.308，P=0.002），体重变化与结束日期时的SDS之间存在负相关（γ=-0.353，P<0.001）。年龄调整后的相关性显示，体重变化与SDS之间最终存在负相关（γ=-0.331，P=0.001）。MMSE和年龄调整后的相关性显示，结束日期时体重变化与SDS之间存在低负相关（γ=-0.333，P=0.001）。
中期PwPD患者体重减轻更可能随年龄增加而出现，体重减轻≥5%与抑郁加重相关。关于PwPD患者体重减轻的意义，还需要进一步研究。
