Correlation Between Serum 25-hydroxyvitamin D And Motor And Non-motor Symptoms In Patients With Parkinson's Disease

Background:Parkinson's disease(PD)is the second most common irreversible neurodegenerative disease.Its clinical manifestations include motor symptoms and a variety of non-motor symptoms.With the progress of the disease,the motor symptoms of PD patients are gradually aggravated,and the types of non-motor symptoms are increasing,which leads to the deterioration of the quality of life.Vitamin D deficiency is widespread,and previous studies have found that v itamin D deficiency is not only associated with the well-known skeletal system,but also affects the nervous system,especially neurodegenerative diseases including PD.Objective:to study the correlation between vitamin D and motor symptoms and non-motor symptoms of PD,and to explore the value of monitoring vitamin D level in the management of PD disease.Methods:A total of 122 PD patients admitted to Subei people's Hospital from August 2018 to December 2019 were collected.The age,sex,education years,smoking history,drinking history,pesticide exposure history,disease course and outdoor activity time were recorded.Through detailed medication,the equivalent dose of levodopa(LED)was calculated.The severity of motor symptoms was evaluated by Hoehn-Yahr stage(H-Y stage)and the third part of the unified Parkinson's disease comprehensive rating scale(UPDRS-III).The overall situation of non-motor symptoms in 122 patients with PD was screened and understood by non-motor symptoms questionnaire(NMSQ).Cognitive impairment,autonomic nervous dysfunction,sleep disorder,depression,fatigue and smell were assessed by Mini-Mental State examination scale(MMSE),Montreal Cognitive Assessment scale(Mo CA),The scale for outcomes in PD for autonomic symptoms(SCOPA-AUT),Pittsburgh Sleep Index scale(PSQI),Hamilton Depression scale(HAMD),fatigue severity scale(FSS)and Argentine olfactory deficit rating scale(AHRS).Fasting serum 25 hydroxyvitamin D(25(OH)D))was measure d to reflect the level of vitamin D,and biochemical indexes such as serum calcium,uric acid,urea nitrogen and creatinine were measured,and the blood sampling season was recorded.According to the deficiency of serum 25(OH)D level,the subjects were divided into vitamin D deficiency group and vitamin D non-deficiency group.The differences of baseline data,exercise score and non-exercise score between groups were compared by univariate analysis.Correlation analysis and multiple linear regression anal ysis were used to explore the exercise and non-exercise symptoms related to vitamin D in PD patients.Results:1.The average level of 25(OH)D in total serum was 43.24 nmol / L,and the proportion of deficiency group was 76.23%.The course of disease,H-Ystage,UPDRS-III score,NMSQ score and SCOPA-AUT score in the deficiency group were higher than those in the non-deficiency group,while the MMSE score and Mo CA score in the deficiency group were lower than those in the non-deficiency group(p<0.05).2.The incidence of at least one non-motor symptom in 122 patients with PD was 100%.The highest incidence rates were constipation(62.5%),near memory loss(60.23%),depression(59.09%),dysosmia(53.41%),dream(52.27%),anxiety(50.00%)and inability to concentrate(48.86%).3.There was no significant difference in blood 25(OH)D in different seasons and outdoor activities(p>0.05).4.The course of disease,age,LED,blood 25(OH)D,serum calcium,NMSQ score,Mo CA score were independently correlated with H-Ystage(p<0.05),and the course of disease,LED,blood 25(OH)D,serum calcium,NMSQ score,Mo CA score were independently correlated with UPDRS-III score(p<0.05),and education years,blood 25(OH)D score,UPDRS-III score were independently correla ted with MMSE score(p<0.05).The years of education,blood 25(OH)D,UPDRS-III score,NMSQ score and Mo CA score were independently correlated(p<0.05).Conclusion:1.the proportion of vitamin D deficiency in PD patients is higher,and the number of non-motor symptoms in PD patients with vitamin D deficiency is more than that in non-deficiency patients,and the motor symptoms,autonomic nerve dysfunction and cognitive impairment are more severe than those in non-deficiency patients.2.Serum vitamin D level is an independent influencing factor of exercise severity and cognitive impairment in patients with PD.