Clinical Observation Of 25-Hydroxyvitamin D Level And Osteoporosis In Parkinson's Disease Patients

Objective:Parkinson's disease?PD?and osteoporosis are common diseases affecting the elderly.More and more evidences show that Parkinson's disease patients have high risk of osteoporosis,vitamin D level is significantly lower than normal people,vitamin D is closely related to fracture and Parkinson's disease.The purpose of this study is to explore the risk factors of osteoporosis in patients with Parkinson's disease and the relationship between vitamin D and Parkinson's disease.Methods:PD patients in outpatient department and inpatient department of neurology of The First Hospital of Hebei Medical University from January2016 to December 2019 were collected as case group?PD group?,and healthy physical examination population matched with age,gender and Body mass index?BMI?was taken as healthy control group.Dual-energy x-ray absorptiometry?DEXA?was used to measure bone mineral density?BMD?of lumbar spine and lateral femoral neck of all subjects.Enzyme-linked immunosorbent assay was used to detect serum 25-hydroxyvitamin D level.The onset age,Levodopa equivalent daily dose?LED?,and serum homocysteine?Hcy?level of PD patients were collected.They were scored by the International Association movement disorder society unified Parkinson's disease rating scale??MDS-UPDRS??and Hoehn-Yahr stage?H-Y stage?.The scores of non-motor symptoms mainly include Hamilton Anxiety Scale 14item(HAMA₁₄),Hamilton Depression Scale 24 item(HAMD₂₄),Mini-Mental State Examination?MMSE?,Montreal Cognitive Assessment?Mo CA?,and Pittsburgh Sleep Quality Index?PSQI?.Results:1. The BMD of femoral neck,total BMD of lumbar spine,T-value of femoral neck,total T-value of lumbar spine and 25-hydroxyvitamin D in PD group were lower than those in control group,the difference was statistically significant?P<0.05?.The osteoporosis rate and 25-hydroxyvitamin D deficiency rate in PD group were higher than those in control group,and the difference was statistically significant?P=0.04,P=0.02?.2. Logistic regression of osteoporosis in PD patients showed that female[P=0.006,OR=46.637,95%CI?2.975?731.012?],Levodopa equivalent daily dose?LED?[P=0.011,OR=1.005,95%CI?1.001?1.009?],Hyperhomocysteinemia?HHcy?[P=0.035,OR=13.672,95%CI?1.195?156.452?]and late H-Y stage(P=0.042,OR=13.225,95%CI?1.093?159.957?]are risk factors,BMI(P=0.004,OR=0.571,95%CI?0.388?0.841?]are independent protection factors.3. The H-Y staging level of PD patients with 25-hydroxyvitamin D deficiency group is higher than that of PD patients without 25-hydroxyvitamin D deficiency group,with significant difference?P=0.003?.There is no significant difference in MDS-UPDRS?,HAMA₁₄,HAMD₂₄,MMSE,Mo CA and PSQI between the two groups.PSQI scores and H-Y staging grades of PD patients with 25-hydroxyvitamin D<16.97ng/ml group are higher than those of PD patients with 25-hydroxyvitamin D?16.97ng/ml group,with statistically significant difference?P=0.004,P=0.012?.There is no statistically significant difference in scores of MDS-UPDRS?,HAMA₁₄,HAMD₂₄,MMSE and Mo CA between the two groups.Conclusion:The bone mineral density and 25-hydroxyvitamin D level of PD patients are lower than those of healthy people matched by age,sex and BMI,and the incidence of osteoporosis and vitamin D deficiency is higher than that of healthy people.Female,low BMI,hyperhomocysteinemia,high Levodopa equivalent daily dose and late H-Y stage are all risk factors for osteoporosis in PD patients.The level of 25-hydroxyvitamin D is related to H-Y stage and PSQI of PD patients.PD patients with 25-hydroxyvitamin D<16.97ng/ml have higher disease severity and worse sleep quality.