Division of Geriatrics, Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
Department of Health Sciences, Medical School of Universidade de Fortaleza, Fortaleza, Ceará, Brazil.
Front Endocrinol (Lausanne). 2024 Apr 22;15:1326212. doi: 10.3389/fendo.2024.1326212. eCollection 2024.
Parkinson's disease (PD) is the second most common neurodegenerative illness and has the highest increase rate in recent years. There is growing evidence to suggest that PD is linked to higher osteoporosis rates and risk of fractures.
This study aims to estimate the prevalence and factors associated with osteoporosis as defined by the National Osteoporosis Foundation (NOF) and World Health Organization in patients with mild to moderate PD.
We performed a cross-sectional study at a tertiary public hospital in Fortaleza, Brazil, dating from May 2021 until April 2022. The study sample was comprised of patients with mild to moderate PD who were at least 40 years old and who had the ability to walk and stand unassisted. Bone Mineral Density (BMD) of both the hip (neck of the femur) and the lumbar spine were obtained via properly calibrated Dual Energy X-ray Absorptiometry (DXA) scanning. The FRAX (Fracture Risk Assessment Tool) score was used to determine a person's 10-year risk of major osteoporotic fracture. The Revised European Working Group on Sarcopenia in Older People (EWGSOP 2) was used as a basis to confirm a sarcopenia diagnosis with the following parameters: low muscle strength gauged by handgrip strength and low muscle quantity by DXA. Physical performance was carefully evaluated by using the Short Physical Performance Battery test. Osteoporosis and osteopenia were diagnosed following the NOF guidelines and WHO recommendations.
We evaluated 107 patients in total, of whom 45 (42%) were women. The group's mean age was 68 ± 9 years, and the mean disease time span was 9.9 ± 6.0 years and mean motor UPDRS was 43 ± 15. We found that 42.1% and 34.6% of the sample had osteopenia and osteoporosis following NOF criteria, respectively, and 43% and 33.6% following the WHO recommendations. Lower lean appendicular mass was associated to osteopenia and osteoporosis in multinomial logistic regression analysis in both diagnostic criteria.
Our findings provide additional evidence for the protective role of lean mass against osteoporosis in patients with PD.
帕金森病（PD）是第二常见的神经退行性疾病，近年来发病率增长最快。越来越多的证据表明，PD 与更高的骨质疏松症发病率和骨折风险有关。
本研究旨在评估轻度至中度 PD 患者中，根据国家骨质疏松基金会（NOF）和世界卫生组织（WHO）定义的骨质疏松症的患病率和相关因素。
我们在巴西福塔莱萨的一家三级公立医院进行了一项横断面研究，时间为 2021 年 5 月至 2022 年 4 月。研究样本包括年龄至少 40 岁、能够独立行走和站立的轻度至中度 PD 患者。通过适当校准的双能 X 线吸收法（DXA）扫描获得髋部（股骨颈）和腰椎的骨密度（BMD）。使用 FRAX（骨折风险评估工具）评分来确定一个人 10 年内发生主要骨质疏松性骨折的风险。使用修订后的欧洲老年人肌肉减少症工作组（EWGSOP 2）作为基础，通过握力测量的低肌肉力量和 DXA 测量的低肌肉量来确认肌肉减少症的诊断。通过使用简短身体表现电池测试仔细评估身体表现。根据 NOF 指南和 WHO 建议诊断骨质疏松症和骨量减少症。
我们总共评估了 107 名患者，其中 45 名（42%）为女性。该组的平均年龄为 68 ± 9 岁，疾病平均持续时间为 9.9 ± 6.0 年，平均运动 UPDRS 为 43 ± 15。我们发现，根据 NOF 标准，样本中有 42.1%和 34.6%分别患有骨质疏松症和骨量减少症，根据 WHO 建议，有 43%和 33.6%分别患有骨质疏松症和骨量减少症。在多元逻辑回归分析中，两种诊断标准下，较低的瘦附肢质量与骨质疏松症和骨量减少症相关。
我们的发现为 PD 患者中瘦质量对骨质疏松症的保护作用提供了额外的证据。
