The Relationship Between Vitamin D And Non-motor Symptoms In Parkinson’s Disease Patients

Objective: The study aims to compare the non motor symptoms(NMS) in Parkinson’s disease(PD) patients with different plasma levels of 25-hydroxy-vitamin D.Methods: Serum 25-hydroxyvitamin D and bone mineral density(BMD) were examined for 183 PD patients and 185 controls. Measures of global NMS(NMSQ),autonomic symptoms(SCOPA-AUT), cognitive function(MMSE, MOCA), excessive daytime sleepiness(EDS), fatigue(FSS), depression(HAMD), anxiety(HAMA), sleep quality(PSQI), quality of life(PDQ-39) and PD severity(Hoehn & Yahr and Unified Parkinson’s Disease Rating Scale) were administered. Total 25(OH)D was categorized by clinical insufficiency or deficiency.Results: 1. Total 25-hydroxy-vitamin D levels, the traditional composite measure of endogenous and exogenous vitamin D, were deficient in 67.9% of patients with PD compared with 95.1% of controls(P=0.006). PD patients had lower 25(OH) D serum levels than controls. 2. Vitamin D deficiency(total 25[OH] D< 30 nmol/L) was associated with PD risk(odds ratio 1.937, P=0.006), adjusting for age, sex, and BMI. 3. Vitamin D deficiency group had significantly higher scores of PSQI(6.00 [4.00-10.00] vs 4.00[2.75,6.00], P = 0.042), HAMD(10.52±9.04 vs 7.03±6.05, P= 0.041), HAMA(8.60 ±7.15 vs 5.03 ± 5.22, P = 0.042) as well as higher prevalence of falls and insomnia. 4. The mean BMD in the the first four lumbar and femoral neck were significantly lower in PD patients than controls. However, the mean BMD of vitamin deficiency did not differ significantly from those of vitamin insufficiency in PD patients, neither in the first four lumbar vertebrae nor femoral neck.Conclusions: Our study reveals an association between 25-hydroxy-vitamin D and PD and suggests that thousands of patients with PD in China alone may be vitamin D deficient. And patients with vitamin D deficiency may suffer with more and severe NMS,including anxiety, depression, falls and insomnia.