Clinical characteristics and risk factors of Parkinson's disease with white matter lesions

doi:10.3969/j.issn.1004-583X.2024.03.004

Abstract

Abstract:

Objective To explore the clinical characteristics and related risk factors of Parkinson's disease (PD) patients with white matter lesions (WML). Methods A total of 127 PD patients admitted to the Neurology Department of Suzhou Hospital Affiliated to Anhui Medical University from February 2022 to September 2023 were selected, and their clinical data were collected. According to the modified Fazekas scale, participants were divided into normal group (n=15), mild abnormal group (n=43), moderate abnormal group (n=45), and severe abnormal group (n=24). The clinical data differences among the four groups were compared. Spearman correlation analysis and multivariate logistic regression analysis were used to study the risk factors for the severity of WML in PD patients. Results There were no significant differences in the gender, hypertension, diabetes, coronary heart disease, Self-Rating Anxiety/ Depression Scale score, Parkinson's Disease Sleep Scale score, uric acid, triglycerides, total cholesterol and low-density lipoprotein cholesterol among the four groups (P>0.05). There were significant differences in the age, Unified Parkinson Disease Rating Scale-part Ⅲ (UPDRS Ⅲ), Hoehn and Yahr (HY) staging, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) score, homocysteine (HCY), and high-density lipoprotein cholesterol (HDL-C) levels (P<0.05). Age, UPDRS Ⅲ scores, HY staging, and HCY level were positively correlated with the severity of WML in PD patients (r=0.759, 0.319, 0.378, and 0.545, respectively; P<0.01). The MMSE score, MoCA score, and HDL-C level were negatively correlated with the severity of WML in PD patients (r=-0.510, -0.524, and -0.319, respectively; P<0.01). Age and HCY level were risk factors for the severity of WML in PD patients (P<0.05), while HDL-C level was a protective factor (P<0.05). Conclusion WML exacerbates motor symptoms and cognitive impairment in PD patients. The age and HCY are risk factors for the severity of WML in PD patients, while HDL-C is a protective factor.

Key words: Parkinson disease, white matter lesions, clinical features, risk factors

CLC Number:

R742.5

Li Qian, Zhong Ping. Clinical characteristics and risk factors of Parkinson's disease with white matter lesions[J]. Clinical Focus, 2024, 39(3): 222-226.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.03.004

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I3/222

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References 28

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组别	例数	年龄 (岁)				性别[例(%)]								高血压 [例(%)]			糖尿病 [例(%)]			冠心病 [例(%)]
组别	例数	年龄 (岁)				男				女				高血压 [例(%)]			糖尿病 [例(%)]			冠心病 [例(%)]
正常组	15	50.93±3.52				8(53.3)				7(46.7)				5(33.3)			1(6.7)			1(6.7)
轻度异常组	43	67.58±6.59^*				22(51.2)				21(48.8)				18(41.9)			9(20.9)			7(16.3)
中度异常组	45	73.76±4.88^*#				22(48.9)				23(51.1)				23(51.1)			13(28.9)			15(33.3)
重度异常组	24	79.67±5.18^*#△				15(62.5)				9(37.5)				15(62.5)			6(25.0)			5(20.8)
F/χ²值		96.151				1.230								4.138			3.314			6.253
P值		<0.01				0.746								0.247			0.346			0.100
组别	H-Y分级 (级)				UPDRS-Ⅲ评分 (分)				MMSE评分 (分)				MoCA评分 (分)				SDS评分 (分)			SAS评分 (分)
正常组	1.63±0.64				20.27±15.13				26.93±3.39				25.80±3.38				43.92±13.06			43.17±11.82
轻度异常组	2.35±0.81^*				30.98±12.98^*				24.14±4.23				21.28±5.92^*				47.37±11.06			49.25±12.60
中度异常组	2.68±1.05^*				35.16±13.65^*				19.64±6.84^*#				16.33±6.50^*#				49.97±11.03			50.52±9.62
重度异常组	3.04±1.05^*#				39.71±18.61^*#				18.00±5.47^*#				14.75±6.09^*#				48.40±12.96			49.11±12.60
F/χ²值	7.964				6.039				17.593^▲				25.198^▲				1.090			1.548
P值	<0.01				0.010				<0.01				<0.01				0.356			0.205
组别	PDSS评分 (分)		UA (μmol/L)				HCY (μmol/L)				TG (mmol/L)				TC (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)
正常组	106.60±31.69			274.11±89.52				12.26±2.85				4.12±0.92				1.77±1.74		1.30±0.33			2.55±0.76
轻度异常组	99.72±22.91			291.51±85.14				12.90±4.15				4.56±1.09				1.10±0.54		1.22±0.25			2.68±0.94
中度异常组	89.82±25.71			270.24±67.89				15.15±3.99^*#				4.37±1.23				1.14±0.58		1.16±0.25			2.42±1.04
重度异常组	96.79±18.84			270.71±82.71				21.40±5.30^*#△				4.12±0.92				1.22±1.16		0.98±0.26^*#△			2.26±0.60
F/χ²值	2.227			0.637				24.041				1.070				2.230		6.008			1.287
P值	0.088			0.593				<0.01				0.365				0.088		0.001			0.282

组别	例数	年龄 (岁)				性别[例(%)]								高血压 [例(%)]			糖尿病 [例(%)]			冠心病 [例(%)]
组别	例数	年龄 (岁)				男				女				高血压 [例(%)]			糖尿病 [例(%)]			冠心病 [例(%)]
正常组	15	50.93±3.52				8(53.3)				7(46.7)				5(33.3)			1(6.7)			1(6.7)
轻度异常组	43	67.58±6.59^*				22(51.2)				21(48.8)				18(41.9)			9(20.9)			7(16.3)
中度异常组	45	73.76±4.88^*#				22(48.9)				23(51.1)				23(51.1)			13(28.9)			15(33.3)
重度异常组	24	79.67±5.18^*#△				15(62.5)				9(37.5)				15(62.5)			6(25.0)			5(20.8)
F/χ²值		96.151				1.230								4.138			3.314			6.253
P值		<0.01				0.746								0.247			0.346			0.100
组别	H-Y分级 (级)				UPDRS-Ⅲ评分 (分)				MMSE评分 (分)				MoCA评分 (分)				SDS评分 (分)			SAS评分 (分)
正常组	1.63±0.64				20.27±15.13				26.93±3.39				25.80±3.38				43.92±13.06			43.17±11.82
轻度异常组	2.35±0.81^*				30.98±12.98^*				24.14±4.23				21.28±5.92^*				47.37±11.06			49.25±12.60
中度异常组	2.68±1.05^*				35.16±13.65^*				19.64±6.84^*#				16.33±6.50^*#				49.97±11.03			50.52±9.62
重度异常组	3.04±1.05^*#				39.71±18.61^*#				18.00±5.47^*#				14.75±6.09^*#				48.40±12.96			49.11±12.60
F/χ²值	7.964				6.039				17.593^▲				25.198^▲				1.090			1.548
P值	<0.01				0.010				<0.01				<0.01				0.356			0.205
组别	PDSS评分 (分)		UA (μmol/L)				HCY (μmol/L)				TG (mmol/L)				TC (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)
正常组	106.60±31.69			274.11±89.52				12.26±2.85				4.12±0.92				1.77±1.74		1.30±0.33			2.55±0.76
轻度异常组	99.72±22.91			291.51±85.14				12.90±4.15				4.56±1.09				1.10±0.54		1.22±0.25			2.68±0.94
中度异常组	89.82±25.71			270.24±67.89				15.15±3.99^*#				4.37±1.23				1.14±0.58		1.16±0.25			2.42±1.04
重度异常组	96.79±18.84			270.71±82.71				21.40±5.30^*#△				4.12±0.92				1.22±1.16		0.98±0.26^*#△			2.26±0.60
F/χ²值	2.227			0.637				24.041				1.070				2.230		6.008			1.287
P值	0.088			0.593				<0.01				0.365				0.088		0.001			0.282

影响因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
影响因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
年龄	0.229	0.470	23.873	<0.01	1.257	0.320	1.370
HCY	0.202	0.530	14.587	<0.01	1.224	0.098	0.305
HDL-C	-2.672	0.967	7.638	0.006	0.069	-4.566	0.777

影响因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
影响因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
年龄	0.229	0.470	23.873	<0.01	1.257	0.320	1.370
HCY	0.202	0.530	14.587	<0.01	1.224	0.098	0.305
HDL-C	-2.672	0.967	7.638	0.006	0.069	-4.566	0.777