Session Information
Date: Saturday, October 6, 2018
Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: This study was conducted to determine the associations between the nutritional status and serum nutritional index and motor symptoms among patients with Parkinson’s disease(PD).
Background: PD patients tend to be more prone to nutritional problems. But in China, nutrition of PD patients is seldom considered in the clinical treatment and research. And so far, little is known about both the prevalence of malnutrition in Chinese PD patients and the association between malnutrition. To clarify these aspects, we conducted a study investigating malnutrition and associated factors in PD patients.
Methods: We enrolled in 72 patients with PD and 71 age-and-sex-matched healthy controls in this study and collected their Serum nutritional index, including serum albumin, prealbumin, transferrin, free fatty acid and retinol conjugated protein). The PD participants were interviewed and assessed using various motor and non-motor scales, including Hoehn and Yahr stage (H&Y), daily levodopa equivalent doses (LEDD), Body Mass Index (BMI), unified PD rating scale (UPDRS), Non-Motor Symptoms questionnaire for Parkinson’s disease (NMSS), Mini-mental State Examination (MMSE), the Unified Dyskinesia Rating Scale (UDysRS) and the 39-item Parkinson’s disease questionnaire (PDQ39).
Results: Serum albumin, transferrin, and free fatty acid of case group were significantly lower than those of control group (P <0.05 ~0.01). There was a significant negative correlation between serum albumin and UPDRS II(P=0.0031) and UPDRS IV(P=0.003). The forward binary Logistic regression model indicated that rigidity(OR =1.171, 95%CI: 1.013~1.354, P =0.032), akinesia(OR =1.07, 95%CI: 1~1.144, P =0.048), UDysRS (OR = 1.051, 95%CI: 1.004~1.099, P =0.032) and UPDRS IV(OR = 1.177, 95%CI:1.018 ~1.360, P =0.027) were closely associated with abnormal nutritional status. The differences of rigidity and akinesia in UPDRSIII, MMSE and UPDRS IV between normal nutritional status and abnormal nutritional status PD patients were statistically significant (P<0.05-0.01).
Conclusions: Serum nutritional index (serum albumin, transferrin, and free fatty acid) of case group were significantly lower than those of control group, PD patients tend to be more prone to nutritional deficiencies. In PD patients, the nutritional status and serum nutritional index are closely associated with motor symptoms. The disease duration and age of PD patients are related to the serum nutritional index, and the cognition and levodopa dosage is associated with the nutritional status.
References: 1. Nutt JG, Wooten GF. Diagnosis and Initial Management of Parkinson’s Disease. N Engl J Med. 2005 Sep 8;353(10):1021–7. 2. Zhang Z-X, Roman GC, Hong Z, Wu C-B, Qu Q-M, Huang J-B, et al. Parkinson’s disease in China: prevalence in Beijing, Xian, and Shanghai. Lancet Lond Engl. 2005 Feb 12;365(9459):595–7. 3. Sheard JM, Ash S, Silburn PA, Kerr GK. Prevalence of malnutrition in Parkinson’s disease: a systematic review. Nutr Rev. 2011 Sep;69(9):520–32. 4. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181–4. 5. Jaafar AF, Gray WK, Porter B, Turnbull EJ, Walker RW. A cross-sectional study of the nutritional status of community-dwelling people with idiopathic Parkinson’s disease. BMC Neurol. 2010 Dec 30;10:124. 6. 王引明, 孔亮, 胡玲玲. 帕金森病患者尿酸、超氧化物歧化酶和血清营养指标的变化[J]. 中国现代药物应用, 2013, 7(23):76-77. 7. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Malnutrition in a Sample of Community-Dwelling People with Parkinson’s Disease. PLOS ONE. 2013 Jan 9;8(1):e53290. 8. Tomic S, Pekic V, Popijac Z, Pucic T, Petek M, Kuric TG, et al. What increases the risk of malnutrition in Parkinson’s disease? J Neurol Sci. 2017 Apr 15;375:235–8. 9. van der Marck MA, Dicke HC, Uc EY, Kentin ZHA, Borm GF, Bloem BR, et al. Body mass index in Parkinson’s disease: A meta-analysis. Parkinsonism Relat Disord. 2012 Mar 1;18(3):263–7. 10. Markus HS, Cox M, Tomkins AM. Raised resting energy expenditure in Parkinson’s disease and its relationship to muscle rigidity. Clin Sci Lond Engl 1979. 1992 Aug;83(2):199–204. 11. Bachmann CG, Trenkwalder C. Body weight in patients with Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2006 Nov;21(11):1824–30. 12. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Markers of disease severity are associated with malnutrition in Parkinson’s disease. PloS One. 2013;8(3):e57986. 13. Sharma JC, Bachmann CG, Linazasoro G. Classifying risk factors for dyskinesia in Parkinson’s disease. Parkinsonism Relat Disord. 2010 Sep 1;16(8):490–7. 14. Fereshtehnejad S-M, Ghazi L, Shafieesabet M, Shahidi GA, Delbari A, Lokk J. Motor, psychiatric and fatigue features associated with nutritional status and its effects on quality of life in Parkinson’s disease patients. PloS One. 2014;9(3):e91153. 15. Wang G, Wan Y, Cheng Q, Xiao Q, Wang Y, Zhang J, et al. Malnutrition and associated factors in Chinese patients with Parkinson’s disease: Results from a pilot investigation. Parkinsonism Relat Disord. 2010 Feb;16(2):119–23. 16. Uc EY, Struck LK, Rodnitzky RL, Zimmerman B, Dobson J, Evans WJ. Predictors of weight loss in Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2006 Jul;21(7):930–6. 17. Kim SR, Chung SJ, Yoo S-H. Factors contributing to malnutrition in patients with Parkinson’s disease. Int J Nurs Pract. 2016 Apr;22(2):129–37. 18. Sharma JC, Macnamara L, Hasoon M, Vassallo M, Ross I. Cascade of levodopa dose and weight-related dyskinesia in Parkinson’s disease (LD–WD-PD cascade). Parkinsonism Relat Disord. 2006 Dec 1;12(8):499–505. 19. Mukherjee A, Biswas A, Das SK. Gut dysfunction in Parkinson’s disease. World J Gastroenterol. 2016 Jul 7;22(25):5742–52. 20. Barichella M, Cereda E, Madio C, Iorio L, Pusani C, Cancello R, et al. Nutritional risk and gastrointestinal dysautonomia symptoms in Parkinson’s disease outpatients hospitalised on a scheduled basis. Br J Nutr. 2013 Jul 28;110(2):347–53. 21. Davies KN, King D, Davies H. A study of the nutritional status of elderly patients with Parkinson’s disease. Age Ageing. 1994 Mar;23(2):142–5. 22. Samorukov AE. [Lipid metabolism disorders in parkinsonism and Huntington’s chorea]. Zhurnal Nevropatol Psikhiatrii Im SS Korsakova Mosc Russ 1952. 1980;80(3):348–53. 23. Paul P, Holmes WL. Free fatty acid and glucose metabolism during increased energy expenditure and after training. Med Sci Sports. 1975 Fall;7(3):176–83. 24. Ghazi L, Fereshtehnejad S-M, Abbasi Fard S, Sadeghi M, Shahidi GA, Lokk J. Mini Nutritional Assessment (MNA) is Rather a Reliable and Valid Instrument to Assess Nutritional Status in Iranian Healthy Adults and Elderly with a Chronic Disease. Ecol Food Nutr. 2015;54(4):342–57. 25. Fereshtehnejad S-M, Ghazi L, Sadeghi M, Khaefpanah D, Shahidi GA, Delbari A, et al. Prevalence of malnutrition in patients with Parkinson’s disease: a comparative study with healthy controls using Mini Nutritional Assessment (MNA) questionnaire. J Park Dis. 2014;4(3):473–81. 26. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Improved nutritional status is related to improved quality of life in Parkinson’s disease. BMC Neurol. 2014 Nov 18;14:212.
To cite this abstract in AMA style:
L. Chen, W. Chen, Q. Guo, L. Jiang, Y. Hu, Y. Liu, W. Xian. Association analysis of the nutritional status and serum nutritional index in patients with Parkinson’s disease [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/association-analysis-of-the-nutritional-status-and-serum-nutritional-index-in-patients-with-parkinsons-disease/. Accessed September 7, 2024.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/association-analysis-of-the-nutritional-status-and-serum-nutritional-index-in-patients-with-parkinsons-disease/