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Corresponding Author

Zhihui Duan

Abstract

Background Sufficient attention has not been paid to malnutrition，one of the non-motor symptoms of Parkinson's disease （PD），for a long time. Malnutrition，sarcopenia and balance disorders increase fracture risk in PD patients. Currently，the research in this field is relatively rare in China. Objective To examine sex-specific correlations of nutritional status，bodycomposition and balance condition with fracture risk in PD patients.Methods A total of 68 PD patients （37 males and 31 females）treated in Luoyang Central Hospital Affiliated to Zhengzhou University from December 2018 to December 2020 were enrolled，and their general data were collected. Then，the 10-year risks for major osteoporotic fractures （MOF） and hip fractures （HF） were predicted using the Fracture Risk Assessment Tool. Motor and balance functions were assessed using the Unified Parkinson Disease Rating Scale-part Ⅲ （UPDRS Ⅲ ）. Nutrition status was assessed using the Mini-Nutritional Assessment （MNA）. Balance ability was measured by the Berg Balance Scale （BBS）. Balance confidence for performing activities was rated by the Activities-specific Balance Confidence（ABC） Scale. The T-score of femoral neck bone mineral density（BMD） was calculated and body composition was measured. The correlations of fracture risk with various factors were analyzed. And fracture risk and various factors were subjected to partial correlation analysis after controlling for age，gender and T-score of femoral neck BMD. Results Compared to women PD patients，men had lower the 10-year risk for MOF，UPDRS Ⅲ score，and body fat rate （BFR），as well as greater mean triceps skin fold thickness，but higher mean T-score of femoral neck BMD，mean trunk muscle mass，upper limb muscle mass，lower limb muscle mass and BBS score （P<0.05）. In men PD patients，the 10-year risks for MOF and HF were negatively correlated with the MNA score，lower limbs muscle mass，BBS score and ABC score （P<0.05），but were positively correlated with the UPDRS Ⅲ score （P<0.05）；the T-score of femoral neck BMD was positively correlated with lower limbs muscle mass （P<0.05），while negatively correlated with BFR （P<0.05）. In women PD patients，the 10-year risk for MOF was positively correlated with the UPDRS Ⅲ score and age，while negatively correlated with the MNA score，muscle mass of lower limbs，BBS score and ABC score （P<0.05）；the 10-year risk for HF was positively correlated with the UPDRS Ⅲ score，while negatively correlated with MNA score，muscle mass of upper limbs and lower limbs，BBS score and ABC score （P<0.05）. Besides，the T-score of femoral neck BMD was positively correlated with muscle mass of lower limbs （P<0.05），while negatively correlated with age and waist-to-hip ratio （P<0.05）. The results of partial correlation analysis revealed that the 10-year risks for MOF and HF had negative correlations with MNA score，muscle mass of lower limbs，BBS score and ABC score （P<0.05），and a positive association was found between the 10-year risk for MOF and UPDRS Ⅲ score （P<0.05）. Conclusion The body composition and T-score of femoral neck BMD in males are different from those in females. Malnutrition，decreased muscle mass of lower limbs，reduced balance capacity and severity of PD are important predictors of the risk of MOF in PD patients. In view of this，to prevent and treat osteoporosis and fractures in PD patients，it is essential to pay attention to nutritional status and muscle mass of them，especially female patients.

Original Publcation Date of Chinese Version

2021-12-24

Original Issue

36

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