帕金森病中营养不良发生率的增加及其与临床疾病参数的关系

H S Markus, A M Tomkins, G M Stern
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引用次数: 97

摘要

对95名帕金森病患者(53名男性,42名女性)进行了人体测量学研究。记录体重、身高、肱三头肌和肱二头肌皮肤褶皱厚度、臂中围。营养不良的发生率很高(23.6%的男性和22.5%的女性,根据最近英国指南的定义)。重度残疾帕金森病患者亚组的平均体重指数明显低于慢性锥体上运动神经元病变的类似残疾对照组(男性20.6 v 23.2 kg/m2 p < 0.05;雌性20.6 vs 26.6 kg/m2 (p < 0.01),表明营养不良不仅仅是由于慢性疾病或不活动所致。人体测量指标与疾病临床特征之间的相关性表明,中度或重度运动障碍是与营养不良最密切相关的临床参数。皮肤褶皱厚度(与体脂百分比相关)的人体测量指数下降最为明显,手臂肌肉周长(与瘦体重相关)的人体测量指数下降最少;因此,帕金森氏症患者的体重减轻主要是由于脂肪的减少而不是肌肉的减少。
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Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters.

An anthropometric study was performed in 95 subjects (53 male, 42 female) with Parkinson's disease. Weight, height, triceps and biceps skin-fold thicknesses, and mid-arm circumference were recorded. A high incidence of undernutrition was found (23.6% of males and 22.5% of females, as defined by recent British guidelines). A subgroup of severely disabled patients with Parkinson's disease had a significantly lower mean body mass index than a similarly disabled control group with chronic pyramidal upper motor neuron lesions (males 20.6 v 23.2 kg/m2 p < 0.05; females 20.6 v 26.6 kg/m2 p < 0.01), suggesting that the undernutrition is not due to chronic illness or immobility alone. Correlation between anthropometric indices and clinical features of disease demonstrated that the presence of moderate or severe dyskinetic movements was the clinical parameter most strongly related to undernutrition. The reduction in anthropometric indices was most marked for skin fold thickness (related to percentage body fat) and least for arm muscle circumference (related to lean body mass); therefore the weight loss seen in Parkinson's disease is primarily due to fat loss rather than muscle loss.

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