Vitamin D and other indicators of calcium-phosphorus metabolism as possible predictors of Parkinson’s disease

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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+exp^{2.673–0.007x–0.052y–0.037z–0.012k}), where «x» is the parathyroid hormone level, «y» is T-score NRH, «z» is the vitamin D level, «k» 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.

Keywords:

Parkinson’s disease

vitamin D

densitometry

parathyroid hormone

alkaline phosphatase

Authors:

Novotnij D.A.

City Clinical No.1

Zhukova N.G.

Siberian State Medical University

Shperling L.P.

Regional Center for Extrapyramidal Diseases with Botulinum Therapy Room

Stolyarova V.A.

Siberian State Medical University

Zhukova I.A.

Siberian State Medical University

Agasheva A.E.

Siberian State Medical University

Shtaimets S.V.

City clinic No 3 of the Omsk region

Druzhinina O.A.

City Polyclinic No. 1

Shirokikh I.V.

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Received:

10.01.2022

Accepted:

12.02.2022

List of references:

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266‐281. https://doi.org/10.1056/NEJMra070553
Evatt ML, DeLong MR, Khazai N, et al. Prevalence of vitamin D insufficiency in patients with Parkinson disease and Alzheimer disease. Arch Neurol. 2008;65:1348‐1352. https://doi.org/10.1001/archneur.65.10.1348
Lorefält B, Toss G, Granérus AK. Bone mass in elderly patients with Parkinson’s disease. Acta Neurol Scand. 2007;116:248‐254. https://doi.org/10.1111/j.1600-0404.2007.00875.x
Newmark HL, Newmark J. Vitamin D and Parkinson’s disease — a hypothesis. Mov Disord. 2007;22:461‐22:4. https://doi.org/10.1002/mds.21317
Martignoni E, Godi L, Citterio A. Comorbid disorders and hospitalization in Parkinson’s disease: a prospective study. Neurol Sci. 2004;25:66‐71. https://doi.org/10.1007/s10072-004-0232-5
Evatt ML, DeLong MR, Kumari M. High prevalence of hypovitaminosis D status in patients with early Parkinson disease. Arch Neurol. 2011;68:314‐319. https://doi.org/10.1001/archneurol.2011.30
Ding H, Dhima K, Lockhart KC, et al. Unrecognized vitamin D3 deficiency is common in Parkinson disease: Harvard Biomarker Study. Neurology. 2013;81:1531‐1537. https://doi.org/10.1212/WNL.0b013e3182a95818
Suzuki M, Yoshioka M, Hashimoto M. Randomized, doubleblind, placebo‐controlled trial of vitamin D supplementation in Parkinson disease. Am J Clin Nutr. 2013;97:1004‐1013. https://doi.org/10.3945/ajcn.112.051664
Shrestha S, Lutsey PL, Alonso A, et al. Serum 25‐hydroxyvitamin D concentrations in Mid‐adulthood and Parkinson’s disease risk. Mov Disord. 2016;31:972‐978. https://doi.org/10.1002/mds.26573
Peterson AL, Murchison C, Zabetian C. Memory, mood, and vitamin D in persons with Parkinson’s disease. J Parkinsons Dis. 2013;3:547‐555. https://doi.org/10.3233/JPD-130206
Kwon KY, Jo KD, Lee MK. Low serum vitamin D levels may contribute to gastric dysmotility in de novo Parkinson’s Disease. Neurodegener Dis. 2016;16:199‐205. https://doi.org/10.1159/000441917
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. JNNP. 1992;55:181-184. https://doi.org/10.1136/jnnp.55.3.181
Martínez-Martín P, Rodríguez-Blázquez C, Alvarez M, et al. Parkinson’s disease severity levels and MDS-Unified Parkinson’s Disease Rating Scale. Parkinsonism Relat Disord. 2015;21(1):50-54. https://doi.org/10.1016/j.parkreldis.2014.10.026
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. Journal of the American Geriatrics Society. 2005;53:695-699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67(6):361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Beck AT, Ward C, Mendelson M. Beck Depression Inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
Holick MF, Binkley NC, Bischoff-Ferrari HA. Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 96(7):1911-1930. https://doi.org/10.1210/jc.2011-0385
Melnichenko GA, Belaya ZhE, Rozhinskaya LY. Federal clinical recommendations of diagnostic, treatment and osteoporosis prevention. Problemy Endokrinologii. 2017;63(6):392-426. (In Russ.). https://doi.org/10.14341/probl2017636392-426
Lartey StT, Magnussen CG, Si L, et al. The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization’s Study on global AGEing and adult health. PLOS ONE. 2019;14(1):e0208491. https://doi.org/10.1371/journal.pone.0208491
Belinda B, Peat J. Medical statistics: a guide to SPSS, data analysis, and critical appraisal (2nd edition), Wiley, UK. 2014.
Geng J, Zhang J, Yao F, et al. A systematic review and meta‐analysis of the associations of vitamin D receptor genetic variants with two types of most common neurodegenerative disorders. Aging Clin Exp Res. 2019;12(6):23-29. https://doi.org/10.1007/s40520-019-01135-4
Krisanova N, Pozdnyakova N, Pastukhov A. Vitamin D3 deficiency in puberty rats causes presynaptic malfunctioning through alterations in exocytotic release and uptake of glutamate/GABA and expression of EAAC‐1/GAT‐3 transporters. Food Chem Toxicol. 2019;123:123‐142. https://doi.org/10.1016/j.fct.2018.10.054
Rimmelzwaan LM, van Schoor NM, Lips P, et al. Systematic review of the relationship between vitamin D and Parkinson’s Disease. J Parkinsons Dis. 2016;6:29‐37. https://doi.org/10.3233/JPD-150615
Calvello R, Cianciulli A, Nicolardi G, et al. Vitamin D treatment attenuates neuroinflammation and dopaminergic neurodegeneration in an animal model of Parkinson’s disease, shifting M1 to M2 microglia responses. J Neuroimmune Pharmacol. 2017;12:327‐339.21. https://doi.org/10.1007/s11481-016-9720-7
Lima LAR, Lopes MJP, Costa RO, et al. Vitamin D protects dopaminergic neurons against neuroinflammation and oxidative stress in hemiparkinsonian rats. J Neuroinflammation. 2018;15:249. https://doi.org/10.1186/s12974-018-1266-6
Yeshokumar AK, Saylor D, Kornberg MD, et al. Evidence for the importance of vitamin D status in neurologic conditions. Curr Treat Options Neurol. 2015;17:51. https://doi.org/10.1007/s11940-015-0380-3
Dean ED, Mexas LM, Cápiro NL, et al. 25‐Hydroxyvitamin D depletion does not exacerbate MPTP‐induced dopamine neuron damage in mice. PLoS ONE. 2012;7:e39227. https://doi.org/10.1371/journal.pone.0039227
Knekt P, Kilkkinen A, Rissanen H, et al. Serum vitamin D and the risk of Parkinson disease. Arch Neurol. 2010;67:808‐811. https://doi.org/10.1001/archneurol.2010.120
Anderson C, Checkoway H, Franklin GM, et al. Dietary factors in Parkinson’s disease: the role of food groups and specific foods. Mov Disord. 1999;14:21‐27. https://doi.org/10.1002/1531-8257(199901)14:1<21::aid-mds1006>3.0.co;2-y "> 3.0.co;2-y" target="_blank">https://doi.org/10.1002/1531-8257(199901)14:1<21::aid-mds1006>3.0.co;2-y
Betemps EJ, Buncher CR. Birthplace as a risk factor in motor neurone disease and Parkinson’s disease. Int J Epidemiol. 1993;22:898‐904. https://doi.org/10.1093/ije/22.5.898
Lux WE, Kurtzke JF. Is Parkinson’s disease acquired? Evidence from a geographic comparison with multiple sclerosis. Neurology. 1987;37:467‐471. https://doi.org/10.1212/wnl.37.3.467
Lilienfeld DE, Sekkor D, Simpson S, et al. Parkinsonism death rates by race, sex and geography: a 1980s update. Neuroepidemiology. 1990;9:243‐247. https://doi.org/10.1159/000110780
Lanska DJ. The geographic distribution of Parkinson’s disease mortality in the United States. J Neurol Sci. 1997;150:63‐150. https://doi.org/10.1016/s0022-510x(97)05371-9
Van den Bos F, Speelman AD, Samson M, et al. Parkinson’s disease and osteoporosis. Age Ageing. 2013;42:156‐162. https://doi.org/10.1093/ageing/afs161
Bener A, Saleh NM. Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women. J Midlife Health. 2015;6:108‐114. https://doi.org/10.4103/0976-7800.165590
Li S, Ou Y, Zhang H, et al. Vitamin D status and its relationship with body composition, bone mineral density and fracture risk in urban central south Chinese postmenopausal women. Ann Nutr Metab. 2014;64:13‐19. https://doi.org/10.1159/000358340
Zhao J‐G, Zeng X‐T, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community dwelling older adults: a systematic review and meta‐analysis. JAMA. 2017;318:2466‐2482. https://doi.org/10.1001/jama.2017.19344
Kruavit A, Chailurkit L‐O, Thakkinstian A, et al. Prevalence of vitamin D insufficiency and low bone mineral density in elderly Thai nursing home residents. BMC Geriatr. 2012;12:49. https://doi.org/10.1186/1471-2318-12-49
Hoang MT, DeFina LF, Willis BL, et al. Association between low serum 25‐hydroxyvitamin D and depression in a large sample of healthy adults: the Cooper Center longitudinal study. Mayo Clin Proc. 2011;86:1050‐1055. https://doi.org/10.4065/mcp.2011.0208
Chao YS, Ekwaru JP, Ohinmaa A, et al. Vitamin D and health‐related quality of life in a community sample of older Canadians. Qual Life Res. 2014;23:2569‐23:25. https://doi.org/10.1007/s11136-014-0696-6
Peterson AL, Mancini M, Horak FB. The relationship between balance control and vitamin D in Parkinson’s disease‐a pilot study. Mov Disord. 2013;28:1133‐1137.14. https://doi.org/10.1002/mds.25405
Petersen MS, Bech S, Christiansen DH, et al. The role of vitamin D levels and vitamin D receptor polymorphism on Parkinson’s disease in the Faroe Islands. Neurosci Lett. 2014;561:74‐79. https://doi.org/10.1016/j.neulet.2013.12.053
Jang W, Park J, Kim JS, et al. Vitamin D deficiency in Parkinson’s disease patients with orthostatic hypotension. Acta Neurol Scand. 2015;132:242‐250. https://doi.org/10.1111/ane.12390
Armstrong DJ, Meenagh GK, Bickle I, et al. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol. 2007;26:551‐554. https://doi.org/10.1007/s10067-006-0348-5

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