目的:探讨25羟基维生素D与帕金森病(Parkinson's disease, PD)运动症状的关系。方法:选取2019年1月-2021年12月收治的105例PD患者为PD组,依据MDS-UPDRS Ⅱ～Ⅲ条目计算震颤类项目总分和姿势异常-步态障碍类项目总分,PD患者分为震颤为主型(tremor-dominant, TD)33例、姿势异常-步态障碍型(postural instability/gait difficulty, PIGD)48例、中间型24例。同期50例老年健康体检者为对照组,检测两组的25羟基维生素D、铁蛋白、白蛋白、血尿酸等。结果:PD组维生素D缺乏发生率(82.90%)高于健康对照组(68.00%),差异有统计学意义(P＜0.05)。PD组25羟基维生素D平均水平(15.16±5.13)ng/L低于对照组(17.53±4.88)ng/L,差异有统计学意义(P＜0.05)。PIGD型的25羟基维生素D水平(13.22±4.82)ng/L低于TD型(17.11±4.85)ng/L、低于中间型(16.37±4.90)ng/L的PD患者,差异均有统计学意义(P＜0.017)。25羟基维生素D水平与MDS-UPDRS Ⅲ评分负向强相关(rs=-0.645),25羟基维生素D水平与MDS-UPDRS Ⅲ评分一元线性回归分析呈负向线性相关(B=-2.556,P=0.000)。结论:PD患者维生素D缺乏发生率高,PIGD型PD患者维生素D水平更低。维生素D水平与PD患者临床运动分型及运动症状严重程度相关。
Objective: To investigate the relationship between 25-hydroxyvitamin D and motor symptoms of Parkinson's disease (PD). Methods: A total of 105 PD patients admitted in our hospital from January 2019 to December 2021 were selected as the PD group. The total scores of tremor, postural instability/gait difficulty (PIGD) were calculated according to MDS-UPDRS Ⅱ~Ⅲ item. The PD patients were divided into the tremor-dominant (TD) type (n=33), postural instability/gait difficulty (PIGD) type (n=48), and middle type (n=24). During the same period, 50 elderly health checkups were used as a control group, 25-hydroxyvitamin D, ferritin, albumin, serum uric acid of the two groups of patients were detected. Results: The incidence of vitamin D deficiency in the PD group was 82.90%,which was higher than that in healthy control group 68.00% (34/50), and the difference was statistically significant (P＜0.05). The average level of 25-hydroxyvitamin D in the PD group was 15.16±5.13 ng/L, lower than that of 17.53±4.88 ng/L in control group, and the difference was statistically significant (P＜0.05). The level of 25-hydroxyvitamin D in the PIGD type (13.22±4.82 ng/L) was lower than that in the TD type (17.11±4.85 ng/L) and middle type (16.37±4.90 ng/L) PD patients, and the differences were statistically significant (P＜0.017). There was a strong negative correlation between 25-hydroxyvitamin D level and MDS-UPDRS Ⅲ score (rs=-0.645). Unitary linear regression analysis of 25-hydroxyvitamin D level and MDS-UPDRS Ⅲ score on one-way linear regression analysis (B=-2.556, P=0.000). Conclusion: The incidence of vitamin D deficiency is high in PD patients, and the vitamin D level is lower in the PIGD type PD patients. Vitamin D level is correlated with motor typing and severity of motor symptoms in PD patients.
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