RESTING ENERGY EXPENDITURE IN PARKINSON'S DISEASE PATIENTS UNDER DOPAMINERGIC TREATMENT

Abstract

Weight homeostasis is complex in Parkinson's disease (PD) and body weight changes substantially throughout the course of the disease. We designed a case-control study to i) investigate whether PD is associated with changes in resting energy expenditure (REE), ii) to assess the accuracy of REE predictive equations for healthy people in PD and iii) to eventually construct a new formula. Measured REE (mREE) was compared between 122 PD patients and 122 gender and body mass index (BMI)-matched controls. The accuracy of estimated REE by 5 common equations (Harris/Benedict-1919, Harris/Benedict-1984, Mifflin St. Jeor, WHO/FAO and aggregate formula) was investigated in PD using Bland-Altman analysis and reported as the frequency of accurate predictions (±10%). Concordance correlation coefficients (CCC) were also calculated. Then, we regressed a new REE equation - using gender, age, weight, height and Hoehn-Yahr stage - and validated it in an independent sample (N=100). No significant difference in mREE was recorded between the whole PD sample and healthy controls. However, mREE was increased in patients with BMI≥30 kg/m2 and Hoehn-Yahr stage≥3. Available REE equations showed limited accuracy (accurate prediction [±10%] frequency, <60% for all). For the new equation the proportion of accurate prediction was 67.0% (overestimation, 24.0%) and CCC was 0.77. PD patients are not commonly characterized by an increase in REE. This is limited to patients suffering from obesity and more severe disease. Common REE equations appear to be inaccurate. The new formula provided better REE estimates and its use can be proposed.