OBJECTIVE: To determine the pathogenesis of the stooped posture in Parkinson disease (PD), we prospectively studied fractures in a cohort of patients with Parkinson disease for 5 yrs. DESIGN: At baseline, we recorded the dietary intake of vitamin D and serum concentrations of parathyroid hormone and 25-hydroxyvitamin D. Bone mineral density and lateral thoracic and lumbar spine radiographs were obtained at baseline and every year for 5 yrs. RESULTS: During the 5-yr study period, stooped posture developed in 34 patients; the rest of the 58 patients did not show stooped posture. At baseline, mean serum 25-hydroxyvitamin D and parathyroid hormone levels were 10.9 ng/ml and 73.1 pg/ml, respectively, in the stooped group and 18.6 ng/ml and 56.4 pg/ml, respectively, in the nonstooped group. Bone mineral density in the stooped group was significantly lower than in the nonstooped group. Dietary intake of vitamin D in the stooped group was significantly lower than in the nonstooped group. During the study period, 19 (22%) patients in the nonstooped group developed new vertebral fracture, compared with 23 (100%) patients in the stooped group. The mean +/- SD percentage changes in bone mineral density were -6.5 +/- 0.6 in the stooped group and -3.8 +/- 0.8 in the nonstooped group. Mean serum levels of 25-hydroxyvitamin D after 5 yrs were 7.0 ng/ml in the stooped group and 14.1 ng/ml in the nonstooped group. CONCLUSIONS: Stooped posture in Parkinson disease may be caused by vertebral fractures resulting from vitamin D deficiency with compensatory hyperparathyroidism. Vitamin D supplementation may reduce stooped posture in patients with Parkinson disease
Keywords : Aged,analogs & derivatives,Bone Density,Cohort Studies,complications,deficiency,etiology,Female,Humans,injuries,Japan,Lumbar Vertebrae,Male,metabolism,Middle Aged,Parathyroid Hormone,Parkinson Disease,pathology,Patients,Posture,Spinal Fractures,Spine,Thoracic Vertebrae,Vitamin D,Vitamin D Deficiency,, D,Deficiencyinduced,Vertebral,Fractures,May, cervicogenic headache specialist
Date of Publication : 2011 Apr
Authors : Sato Y;Iwamoto J;Honda Y;
Organisation : Department of Neurology, Mitate Hospital, Tagawa, Japan
Journal of Publication : Am J Phys Med Rehabil
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21273899
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