Kocaeli Med J. 2018; 7(1): 37-41 | DOI: 10.5505/ktd.2018.65487

Role of Body Mass Index of Idiopathic Parkinson Patients on Motor Functions, Disease Progress and Risk of Fall

Aybala Neslihan Alagoz¹, Nimet Uçaroðlu Can², Bilgehan Atýlgan Acar¹, Türkan Acar^1
1Sakarya University Faculty of Medicine, Department of Neurology, Sakarya, Turkey
²Fatih Sultan Mehmet Training and Research Hospital, Neurology Clinic, Ýstanbul, Turkey

INTRODUCTION: Parkinson disease (PD) is the second most common degenerative disease which is characterized by the presence of motor and nonmotor symptoms. Among its symptoms; changes in body mass index (BMI) are also observed. In our study; the relation between the changes in patients’ BMI and patients' motor functions, disease progress and the risk of fall was studied.
METHODS: 113 idiopathic PD patients; who have been under observation for at least 6 months in the Parkinson Disease and Movement Disorders Polyclinic at the Neurology Clinic of the Faculty of Medicine of Sakarya University; were included in our study. The BMI was calculated according to the weight and height values of the patients, the Unified Parkinson Disease Rating Scale (UPDRS), Hoehn Yahr (H-Y) scale and Tinetti balance and gait test were applied.
RESULTS: In the study; a positive significant correlation was found between BMI values and motor UPDRS of the patients (r = 0,22; p = 0.019). There was no statistically significant relationship between BMI values and H-Y scale (r = 0,049; p = 0,607). According to Tinetti balance and gait test; the patients were classified in 3 groups as low, medium and high risk groups. For BMI; there was no significant difference between the low, medium and high risk groups. Motor UPDRS average was highest in high risk group, then medium risk group and the lowest average was found in low risk group. Hence; there was a significant difference between 3 groups.
DISCUSSION AND CONCLUSION: Patients with PD begin to lose weight a few years ago before the diagnosis which is suggesting that the weight change is associated with some of the factors that preceded the onset of motor symptoms. PD has traditionally been associated with weight loss. However, recent studies have not found any evidence to suggest that PD is related to being underweight. Contrary to the common belief that low BMI is correlated with PD and negatively affects disease and living standards; in our study it was concluded that as BMI increases, motor deterioration and related risk of falling in PD increase more. There is a need for extensive studies with more patients to support these studies. We think that our study will shed light on the literature as an opposite idea.

Keywords: Idiopathic Parkinson Disease, Body Mass Index, Hoehn Yahr (H-Y) scale, Unified Parkinson's Disease Rating Scale, Tinetti balance and gait test.

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Ýdiopatik Parkinson Hastalarýnda Vücut Kitle Ýndeksinin; Motor Fonksiyonlar, Hastalýk Evresi ve Düþme Riski Üzerine Etkisi

Aybala Neslihan Alagoz¹, Nimet Uçaroðlu Can², Bilgehan Atýlgan Acar¹, Türkan Acar^1
1Sakarya Üniversitesi Týp Fakültesi Nöroloji AD, Sakarya, Türkiye
²Fatih Sultan Mehmet Eðitim ve Araþtýrma Hastanesi, Nöroloji Kliniði,Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Parkinson hastalýðý (PH), motor ve nonmotor semptomlarýn varlýðý ile karakterize olan, ikinci en sýk görülen dejeneratif hastalýktýr. SEmptomlarý arasýnda Vücut kitle indeksi (VKÝ) deðiþiklikleride görülür. Çalýþmamýzda; VKÝ deðiþikliklerin hastalarýn motor fonkiyonlarý, hastalýk evresi ve düþme riski ile iliþkisi araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýza Sakarya Üniversitesi Týp Fakültesi Nöroloji Kliniði Parkinson Hastalýðý ve Hareket Bozukluklarý Polikliniðinde en az 6 aydýr takipli 113 Ýdiopatik PH dahil edildi. Hastalarýn kilo ve boy deðerlerine göre VKÝ hesaplandý, Birleþik Parkinson Hastalýðý Derecelendirme Ölçeði (UPDRS), Hoehn Yahr (HY) evrelemesi ve Tinetti denge ve yürüme testi uygulandý.
BULGULAR: Çalýþmada hastalarýn VKÝ deðerleri ile motor UPDRS deðerleri arasýnda pozitif anlamlý korelasyon bulundu (r=0,22; p=0.019). VKÝ deðerleri ile H-Y evresi arasýnda istatistiki olarak anlamlý bir iliþki yoktu (r=0,049; p=0,607).Tinetti denge ve yürüme testine göre, düþük, orta ve yüksek risk olmak üzere 3 gruba ayrýldý.VKÝ bakýmýndan düþük, orta ve yüksek riskli gruplar arasýnda anlamlý farka rastlanmadý. Motor UPDRS ortalamasý en yüksek; yüksek riskli grup, daha sonra orta riskli grup ve en düþük; düþük riskli grupta bulundu yani 3 grup arasýnda da anlamlý fark vardý.
TARTIÞMA ve SONUÇ: PH olan hastalar tanýdan birkaç yýl önce kilo vermeye baþlar, bu da kilo deðiþiminin motor semptomlarýn baþlangýcýndan önce gelen bazý faktörlerle iliþkili olduðunu gösterir. PH geleneksel olarak kilo kaybýyla iliþkilendirilmiþtir. Bununla birlikte, yakýn tarihli çalýþmalarda PH’nýn düþük kilolu olmak ile ilgili olduðunu kanýtlayan herhangi bir bulgu bulunamamýþtýr.Düþük VKÝ’nin PH ile iliþkisi ve hastalýk ve yaþam standartlarýný negatif yönde etkilediðine dair kabul gören genel fikrin aksine, bizim çalýþmamýzda; VKÝ arttýkça PH’larýnda motor kötüleþme ve buna baðlý düþme riskinin daha çok arttýðý yönünde sonuçlara ulaþýlmýþtýr. Bu çalýþmalarýn desteklenmesi için daha fazla hasta sayýsý içeren, geniþ kapsamlý çalýþmalara ihtiyaç vardýr. Bir karþýt fikir olarak çalýþmamýzýn literatüre ýþýk tutacaðý kanaatindeyiz.

Anahtar Kelimeler: Ýdiopatik Parkinson Hastalýðý, Vücut Kitle Ýndeksi (VKÝ), Hoehn Yahr (H-Y) evresi, Birleþik Parkinson Hastalýðý Derecelendirme Ölçeði (UPDRS), Tinetti denge ve yürüme testi

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