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J Neurol (2013) 260:754760 DOI 10.1007/s00415-012-6697-x
ORIGINAL COMMUNICATION
Bone mineral density and vitamin D status in Parkinsons disease patients
F. van den Bos A. D. Speelman M. van Nimwegen
Y. T. van der Schouw F. J. G. Backx
B. R. Bloem M. Munneke H. J. J. Verhaar
Received: 2 June 2012 / Revised: 24 September 2012 / Accepted: 26 September 2012 / Published online: 9 October 2012 Springer-Verlag Berlin Heidelberg 2012
Abstract Bone loss is more common in Parkinsons disease (PD) than in the general population. Several factors may be involved in the development of bone loss, including malnutrition, immobilization, low body mass index, decreased muscle strength, vitamin D deciency and medication use. This study investigates the prevalence of osteoporosis and possible risk factors associated with bone loss in early stage PD. In 186 PD patients (Hoehn and Yahr stage
12.5, mean age 64.1 years, 71 % men) bone mineral density (BMD) measurements were performed with DEXA. T- and Z-scores were calculated. Univariate linear regression analysis was performed to identify variables that contributed to BMD. 25-OH-vitamin D status of PD patients was compared with 802 controls (mean age 63.3 years, 50 % men) using linear regression analysis. Osteoporosis(11.8 %) and osteopenia (41.4 %) were common in PD patients. Mean Z-score for the hip was 0.24 (SD 0.93), and for the lumbar spine 0.72 (SD 1.91). Female gender, low weight, and low 25-OH-vitamin D were signicantly correlated with BMD of the hip and lumbar spine. PD patients had lower 25(OH)D serum levels than controls (B = -10, p = 0.000). More than half of the patients with early stage PD had an abnormal BMD. Female gender, low weight, and low vitamin D concentration were associated with bone loss. Furthermore, vitamin D concentrations were reduced in PD patients. These results underscore the importance of proactive screening for bone loss and vitamin D deciency, even in early stages of PD.
Keywords Parkinsons disease Bone density
Osteoporosis Vitamin D Vitamin D deciency
Introduction
Parkinsons disease (PD) is a common and incapacitating disorder affecting a sizeable proportion of the ageing community. Patients with PD have an increased risk of sustaining fractures [31, 33]. The main causes for fractures in PD are falls, due to underlying gait and balance disorders, and...