ABSTRACT
OBJECTIVE: To study a role of vitamin D and other indicators of calcium-phosphorus metabolism as possible predictors of Parkinson's disease (PD). MATERIAL AND METHODS: The main group consisted of 138 patients with PD, the control group included 79 patients without PD. Serum levels of 25-hydroxyvitamin D (25[OH]D) were determined by chemo-luminescence immunoassay. Additionally, the following biochemical markers were evaluated: parathyroid hormone, calcitonin, thyroid-stimulating hormone, thyroxine, alkaline phosphatase, inorganic phosphorus, total calcium, ionized calcium, total protein. In addition, densitometry of the spine (1-4 lumbar vertebrae), proximal femurs, and the middle third of the radius was performed. The relationship between the level of vitamin D in blood serum and clinical data was evaluated using correlation analysis. RESULTS: Regression analysis revealed a statistically significant contribution of the levels of parathyroid hormone, vitamin D, alkaline phosphatase and the T-value of the bone density of the neck of the right hip (T-score NRH) to the probability of PD. In the main group, bone mineral density was significantly different between the groups (p=0.028). Also, there was a high incidence of osteopenia (64%) and osteoporosis (73%). Based on the obtained regression equation, the probability of having PD is p=1/(1+exp2.673-0.007x-0.052y-0.037z-0.012k), where «x¼ is the parathyroid hormone level, «y¼ is T-score NRH, «z¼ is the vitamin D level, «k¼ is the activity of alkaline phosphatase, exp is the exponent. CONCLUSION: Vitamin D levels, alkaline phosphatase activity, and T-score NRH have a statistically significant effect on the likelihood of developing PD. With a decrease in the above indicators relative to normal values, the likelihood of having PD increases.
Subject(s)
Calcium , Parkinson Disease , Alkaline Phosphatase , Bone Density , Humans , Parathyroid Hormone , Phosphorus , Vitamin D , VitaminsABSTRACT
OBJECTIVE: To study non-motor conditions in people with diabetes in comparison with patients with cervicalgia. MATERIAL AND METHODS: The study included 170 people. The main group consisted of 120 respondents with cervical dystonia (CD) aged 27 to 82 years. The diagnosis of CD was based on the Clinical guidelines for the diagnosis and treatment of dystonia adopted by the European Federation of Neurological Societies, the Society for Movement Disorders and the All-Russian Society of Neurologists. The control group included 50 patients, aged 25 to 82 years, with pain in the cervical spine due to muscle-tonic and myofascial syndromes. A Visual Analogue scale, the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Pittsburgh Sleep Quality Index (PSQI) were administered to study the asthenic syndrome in all patients. RESULTS AND CONCLUSION: Pain, anxiety, depression, asthenic syndrome, insomnia are statistically significant non-motor conditions in patients with CD compared with patients with cervicalgia. CD significantly affects the physical and psychological aspects, worsening the quality of life of these patients. The following gender differences are identified: in women with CD, non-motor disorders (anxiety, depression, general and physical asthenia, insomnia) are significantly more pronounced and the quality of life is significantly reduced compared to men with CD. For the successful treatment of CD, a multimodal approach is needed that provides the treatment of not only motor, but also non-motor disorders. Early detection and treatment of comorbid conditions is an important step in the treatment of CD.
