Characteristics of gastrointestinal dysfunction and risk factors in patients with Parkinson′s disease

doi:10.3877/cma.j.issn.2095-2015.2023.03.004

Abstract

Abstract:

Objective

To explore the characteristics of gastrointestinal dysfunction in patients with Parkinson′s disease(PD), analyze relevant risk factors, and provide new ideas for the diagnosis and treatment of PD.

Methods

A total of 208 patients with PD admitted to Fuyang People′s Hospital from January 2019 to October 2022 were selected as the PD group, and 208 patients who underwent physical examination during the same time were selected as the control group.The exercise symptoms of PD patients(H-Y scale and UPDRS scale), the types and incidence of gastrointestinal digestive system related symptoms were evaluated.The differences of laboratory indicators between the two groups were compared, including white blood cell count, neutrophil count, lymphocyte count, platelet count, neutrophil/lymphocyte ratio(NLR), red blood cell distribution width(RDW), mean platelet volume(MPV), platelet distribution width(PDW), homocysteine(HCY), blood uric acid(UA), cystatin C(CysC), and inflammatory markers such as interleukin(IL)-2, IL-6 and tumor necrosis factor-α(TNF-α).Through multivariate logistic regression analysis, the correlations between various indicators and gastrointestinal dysfunction in PD patients were investigated.

Results

The common gastrointestinal symptoms of PD patients were constipation(56.7%), dry mouth(40.9%), dysphagia(33.2%)and early satiety(23.6%), and the incidences of the PD group were significantly higher than those of the control group(P<0.05).HCY, UA, CysC, IL-2, IL-6 and TNF-αin the PD group were significantly higher than those in the control group(P<0.05).Logistic regression analysis showed that the score of H-Y scale, the score of UPDRS scale, HCY, CysC and IL-6 were independent risk factors affecting constipation symptom of PD patients.HCY, CysC and IL-6 were also independent risk factors affecting dry mouth, dysphagia and early satiety of PD patients.

Conclusion

Constipation, dry mouth, dysphagia and early satiety are the common types of gastrointestinal dysfunction in PD patients.Movement disorders, HCY, CysC, and IL-6 are the main risk factors.

Key words: Parkinson′s disease, Gastrointestinal dysfunction, Risk factor

Xilin Li, Qiudong Zhang. Characteristics of gastrointestinal dysfunction and risk factors in patients with Parkinson′s disease[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(03): 145-149.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2023.03.004

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2023/V13/I03/145

Figures/Tables 5

References 23

1	Kalia LV, Lang AE. Parkinson′s disease[J]. Lancet，2015，386(9996)：896-912.
2	Lubomski M, Xu X, Holmes AJ, et al. The Gut Microbiome in Parkinson′s Disease: A Longitudinal Study of the Impacts on Disease Progression and the Use of Device-Assisted Therapies[J]. Front Aging Neurosci, 2022，4：875261.
3	Lubomski M, Davis RL, Sue CM. Gastrointestinal dysfunction in Parkinson′s disease[J]. J Neurol，2020，267(5)：1377-1388.
4	Simonet C, Bestwick J, Jitlal M, et al. Assessment of Risk Factors and Early Presentations of Parkinson Disease in Primary Care in a Diverse UK Population[J]. JAMA Neurol，2022，79(4)：359-369.
5	Tansey MG, Wallings RL, Houser MC, et al. Inflammation and immune dysfunction in Parkinson disease[J]. Nat Rev Immunol，2022，22(11)：657-673.
6	中华医学会神经病学分会帕金森病及运动障碍学组，中国医师协会神经内科医师分会帕金森病及运动障碍专业．中国帕金森病的诊断标准(2016版)[J].中华神经科杂志，2016，49(4)：268-271.
7	袁德智，胡洁，赵秋叶，等．帕金森病进展速度与抑郁、睡眠障碍的相关性分析[J].中国医科大学学报，2020，49(4)：326-330.
8	曲艳，李晓红，孙亚南，等．汉化版MDS-UPDRS与传统UPDRS评测帕金森病的比较分析[J].中国康复理论与实践，2019，25(8)：936-939.
9	申婉晴，史新冲，张冰，等．帕金森病非运动症状与纹状体囊泡单胺转运蛋白2密度的相关性[J].中华核医学与分子影像杂志，2021，41(3)：129-135.
10	赵安容，李波，徐世成，等．低频与高频rTMS对帕金森病患者运动功能和自主神经功能障碍的影响[J/OL].中华临床医师杂志(电子版)，2020，14(10)：779-784.
11	Han MN, Finkelstein DI, McQuade RM, et al. Gastrointestinal Dysfunction in Parkinson′s Disease: Current and Potential Therapeutics[J]. J Pers Med, 2022，12(2)：144.
12	Knudsen K, Fedorova TD, Bekker AC, et al. Objective Colonic Dysfunction is Far more Prevalent than Subjective Constipation in Parkinson′s Disease: A Colon Transit and Volume Study[J]. J Parkinsons Dis, 2017，7(2)：359-367.
13	O′Day C, Finkelstein DI, Diwakarla S, et al. A Critical Analysis of Intestinal Enteric Neuron Loss and Constipation in Parkinson′s Disease[J]. J Parkinsons Dis, 2022，12(6)：1841-1861.
14	Rodríguez-Ramallo H, Báez-Gutiérrez N, Prado-Mel E, et al. Association between Anticholinergic Burden and Constipation: A Systematic Review[J]. Healthcare (Basel), 2021，9(5)：581.
15	O′Donovan SM, Crowley EK, Brown JR, et al. Nigral overexpression of α-synuclein in a rat Parkinson′s disease model indicates alterations in the enteric nervous system and the gut microbiome[J]. Neurogastroenterol Motil, 2020，32(1)：e13726.
16	Barbe AG, Heinzler A, Derman S, et al. Hyposalivation and xerostomia among Parkinson′s disease patients and its impact on quality of life[J]. Oral Dis, 2017，23(4)：464-470.
17	Umemoto G, Fujioka S, Iwasa Y, et al. Impact of Progression of Parkinson′s Disease on Swallowing Ability and Oral Environment[J]. Parkinsons Dis, 2021，2021：5571556.
18	Bhidayasiri R, Phuenpathom W, Tan AH, et al. Management of dysphagia and gastroparesis in Parkinson′s disease in real-world clinical practice-Balancing pharmacological and non-pharmacological approaches[J]. Front Aging Neurosci, 2022，14：979826.
19	Sauerbier A, Ray Chaudhuri K. Non-motor symptoms: the core of multi-morbid Parkinson′s disease[J]. Br J Hosp Med (Lond), 2014，75(1)：18-24.
20	杨玉杰，戚志强，陆敏艳，等．同型半胱氨酸与帕金森病的临床相关性研究[J].中华老年心脑血管病杂志，2018，20(3)：305-306.
21	Xiong KP, Dai YP, Chen J, et al. Increased Serum Cystatin C in Early Parkinson′s Disease with Objective Sleep Disturbances[J]. Chin Med J (Engl), 2018，131(8)：907-911.
22	张家和，柯开富，施建生，等．血尿酸、CysC及Hcy与老年帕金森病患者病程及疾病严重程度相关性分析[J].中国医药导报，2022，19(5)：82-85.
23	Yu QJ, Yu SY, Zuo LJ, et al. Parkinson disease with constipation: clinical features and relevant factors[J]. Sci Rep, 2018，8(1)：567.

组别	例数	男/女(例)	年龄(岁，±s)	体重指数(kg/m²，±s)	基础疾病[例(%)]				受教育水平[例(%)]
组别	例数	男/女(例)	年龄(岁，±s)	体重指数(kg/m²，±s)	高血压	高脂血症	糖尿病	脑卒中	小学及以下	中学	大学及以上
PD组	208	143/65	76.14±11.61	23.07±2.27	24(11.5)	8(3.8)	13(6.3)	12(6.3)	111(53.4)	71(34.1)	26(12.5)
对照组	208	147/61	74.22±10.32	23.81±2.05	19(9.1)	10(4.8)	11(5.3)	8(5.3)	108(51.9)	77(37.0)	23(11.1)
t/χ²		0.182	0.215	0.182	0.648	0.232	0.177	0.840		0.468
P		0.749	0.705	0.824	0.520	0.810	0.834	0.493		0.791

组别	例数	男/女(例)	年龄(岁，±s)	体重指数(kg/m²，±s)	基础疾病[例(%)]				受教育水平[例(%)]
组别	例数	男/女(例)	年龄(岁，±s)	体重指数(kg/m²，±s)	高血压	高脂血症	糖尿病	脑卒中	小学及以下	中学	大学及以上
PD组	208	143/65	76.14±11.61	23.07±2.27	24(11.5)	8(3.8)	13(6.3)	12(6.3)	111(53.4)	71(34.1)	26(12.5)
对照组	208	147/61	74.22±10.32	23.81±2.05	19(9.1)	10(4.8)	11(5.3)	8(5.3)	108(51.9)	77(37.0)	23(11.1)
t/χ²		0.182	0.215	0.182	0.648	0.232	0.177	0.840		0.468
P		0.749	0.705	0.824	0.520	0.810	0.834	0.493		0.791

病情评价指标	数据
发病年龄(岁，±s)	71.11±5.16
持续时间(年，±s)	5.03±2.05
霍亚量表[例(%)]
Ⅰ~Ⅱ	112(53.8)
Ⅲ	68(32.7)
Ⅳ~Ⅴ	28(13.5)
统一帕金森评定量表(分，±s)	65.81±12.92
Ⅰ	8.06±4.13
Ⅱ	16.92±4.27
Ⅲ	28.03±9.75
Ⅳ	5.29±2.88

病情评价指标	数据
发病年龄(岁，±s)	71.11±5.16
持续时间(年，±s)	5.03±2.05
霍亚量表[例(%)]
Ⅰ~Ⅱ	112(53.8)
Ⅲ	68(32.7)
Ⅳ~Ⅴ	28(13.5)
统一帕金森评定量表(分，±s)	65.81±12.92
Ⅰ	8.06±4.13
Ⅱ	16.92±4.27
Ⅲ	28.03±9.75
Ⅳ	5.29±2.88

组别	例数	味觉障碍	吞咽困难	流涎	早期饱腹感	便秘	稀便	大便失禁	食欲不振	口干	口腔疼痛	恶心	呕吐
PD组	208	33(15.9)	69(33.2)	19(9.1)	49(23.6)	118(56.7)	4(1.9)	1(0.5)	41(19.7)	85(40.9)	11(5.3)	22(10.6)	7(3.4)
对照组	208	20(9.6)	12(5.7)	9(4.3)	24(11.5)	12(5.8)	2(1.0)	0(0.0)	29(13.9)	8(3.8)	4(1.9)	14(6.7)	1(0.5)
χ²		3.654	49.81	3.829	10.384	125.717	0.676	1.002	2.473	82.109	3.389	1.946	4.588
P		0.077	<0.001	0.077	0.002	<0.001	0.685	1.000	0.149	<0.001	0.112	0.222	0.068

Please choose a citation manager

Content to export