Progressive and accelerated weight and body fat loss in Parkinson's disease: A three-year prospective longitudinal study. (August 2020)

• Record Type: Journal Article
• Authors: Yong, Voon Wei; Tan, Yan Jing; Ng, Yi-De; Choo, Xing Yan; Sugumaran, Kavita; Chinna, Karuthan; Md Shah, Mohammad Nazri; Raja Aman, Raja Rizal Azman; Moy, Foong Ming; Mohd Ramli, Norlisah; Grossmann, Mathis; Lim, Shen-Yang; Tan, Ai Huey
• Is Part Of: Parkinsonism & related disorders. Volume 77(2020)
• Page Start: 28
• Page End: 35
• Publication Date: 2020-08
• Subjects: Parkinson's disease -- Weight loss -- Body composition -- Fat -- Nutrition -- DXA; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2020.06.015
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Although weight loss is common in Parkinson's disease (PD), longitudinal studies assessing weight and body composition changes are limited. Methods: In this three-year longitudinal study, 125 subjects (77 PD patients and 48 spousal/sibling controls) underwent clinical, biochemical and body composition assessments using dual-energy X-ray absorptiometry. Results: Patients were older than controls (65.6 ± 8.9 vs. 62.6 ± 7.1, P = 0.049), with no significant differences in gender, comorbidities, dietary intake and physical activity. Clinically significant weight loss (≥5% from baseline weight) was recorded in 41.6% of patients, with a doubling of cases (6.5 to 13.0%) classified as underweight at study end. Over three years, patients demonstrated greater reductions in BMI (mean −1.2 kg/m 2, 95%CI-2.0 to −0.4), whole-body fat percentage (−2.5% points, 95%CI-3.9 to −1.0), fat mass index (FMI) (−0.9 kg/m 2, 95%CI-1.4 to −0.4), visceral fat mass (−0.1 kg, 95%CI-0.2 to 0.0), and subcutaneous fat mass (−1.9 kg, 95%CI-3.4 to −0.5) than in controls, with significant group-by-time interactions after adjusting for age and gender. Notably, 31.2% and 53.3% of patients had FMI<3rd (severe fat deficit) and <10th centiles, respectively. Muscle mass indices decreased over time in both groups, without significant group-by-time interactions. Multiple linear regression models showed that loss of body weight and fat mass in patients were associated with age, dyskinesia, psychosis and constipation. Conclusions: We found progressive loss of weight in PD patients, with greater loss of both visceral and subcutaneous fat, but not muscle, compared to controls. Several associated factors (motor and non-motor disease features) were identified for these changes, providing insights on possible mechanisms and therapeutic targets. Highlights: 42% of patients with Parkinson's disease had significant weight loss over 3 years. Patients had greater reductions in body fat (including visceral fat) vs. controls. There were no between-group differences in the change in muscle mass parameters. Worsening psychosis was associated with weight loss in PD. Constipation severity and worsening dyskinesia were associated with fat loss in PD.