Abstract
BackgroundParkinson’s disease (PD) is responsible for significant changes in body composition.AimsWe aimed to test the association between PD severity and fat distribution patterns, and to investigate the potential modifier effect of nutritional status in this association.MethodsWe enrolled 195 PD subjects consecutively admitted to a university geriatric day hospital. All participants underwent comprehensive clinical evaluation, including assessment of total and regional body composition (dual-energy X-ray absorptiometry, DXA), body mass index, nutritional status (Mini-Nutritional Assessment, MNA), motor disease severity (UPDRS III), comorbidities, and pharmacotherapy.ResultsThe fully adjusted linear regression model showed a negative association between UPDRS III and total body fat in kg and percentage (respectively, B − 0.79; 95% CI − 1.54 to − 0.05 and B − 0.55; 95% CI − 1.04 to − 0.05), percentage android fat (B − 1.07; 95% CI − 1.75 to − 0.39), trunk–leg fat ratio (B − 0.02; 95% CI − 0.04 to − 0.01), trunk–limb fat ratio (B − 0.01; 95% CI − 0.06 to − 0.01) and android–gynoid fat ratio (B − 0.01; 95% CI − 0.03 to − 0.01). After stratification by MNA score, all the parameters of android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5 (risk of malnutrition or malnutrition).ConclusionWe found a negative association between severity of motor impairment and total fat mass in PD, more specific with respect to an android pattern of fat distribution. This association seems to be driven by nutritional status, and is significant only among patients at risk of malnutrition or with overt malnutrition.
Highlights
Aging and neurodegenerative diseases are both associated with qualitative and quantitative changes in body composition [1, 2], and specificUniversity, Tomtebodavägen 18A, Solna, Stockholm 17165, Sweden 4 Department of Geriatrics, Campus Bio-Medico University, Rome, Italy 5 Institute of Neurology, Università Cattolica del Sacro Cuore di Roma and IRCCS Fondazione Policlinico “A. Gemelli”, Rome, Italy 6 “Don Gnocchi” Foundation, Milan, Italy1 3 Vol.:(0123456789)Aging Clinical and Experimental Research (2020) 32:77–84 patterns of fat content and distribution have been described across neurodegenerative conditions [2]
After entering the Mini-Nutritional Assessment (MNA) score in the adjusted model, only android fat as % and trunk–leg fat ratio were still negatively associated with Unified Parkinson’s Disease Rating Scale (UPDRS) III, but the association was weaker
All the parameters indicating an android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5
Summary
After stratification by MNA score, all the parameters of android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5 (risk of malnutrition or malnutrition). Conclusion We found a negative association between severity of motor impairment and total fat mass in PD, more specific with respect to an android pattern of fat distribution. This association seems to be driven by nutritional status, and is significant only among patients at risk of malnutrition or with overt malnutrition
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