Parkinson Hastalarında D Vitamini Düzeyleri ile Arteriyel Sertlik İlişkisi

Öz

Amaç: Parkinson hastalarında arteriyel sertliği nabız dalga hızı (NDH) ile serum 25 hidroksi vitamin D [25(OH)D] düzeyleri ve otonomik fonksiyon arasındaki ilişkiyi değerlendirmek. Gereç ve Yöntem: Antalya Eğitim ve Araştırma Hastanesi hareket bozuklukları polikliniğinde izlenen 92 Parkinson hastası ve 73 sağlıklı kontrol çalışmaya dahil edildi. Tüm katılımcılarda kış döneminde 25(OH)D ölçümleri yapıldı; NDH ölçümleri standartize cihazla alındı. Çok değişkenli lineer regresyon ile NDH üzerine etkili faktörler (yaş, cinsiyet, ortalama arter basıncı (OAB), HbA1C, Total kolesterol, Vücut kitle indeksi (VKİ), trigiserit, D vitamini, Parkinson Hastalığının varlığı durumu) incelendi. Bulgular: Toplam 165 katılımcı değerlendirildi. Hasta grubunda 25(OH)D düzeyleri kontrole göre anlamlı olarak daha düşüktü (medyan 15.00 vs 22.00 ng/mL, p<0.001) ve NDH değerleri daha yüksekti (medyan 8.50 vs 7.70 m/s, p=0.030) (Tablo 1). Çok değişkenli analizde Model 1 NDH varyansının %56’sını açıkladı (R²=0.560); yaş (β≈0.70, p<0.001) ve ortalama arter basıncı (OAB) (β≈0.16, p≈0.002–0.004) bağımsız belirleyicilerdi (Tablo 3). D vitamin tek başına bağımsız belirleyici bulunmadı; Model 2’ye eklenen VitD × Parkinson etkileşim terimi modele küçük bir ek katkı sağladı ve sınırda anlamlı bulundu (B=0.048, p=0.056), bu da etkileşime yönelik hipotez oluşturdu. Sonuç: Parkinson hastalarında arteriyel sertlik artışı gözlendi; başlıca belirleyiciler yaş ve otonomik disfonksiyondur. D vitamin düzeyleri hasta grubunda daha düşük olup, D vitamin ile Parkinson varlığı arasındaki sınırda anlamlı etkileşim ileri çalışmalarda test edilmelidir. NDH ölçümü Parkinson popülasyonunda kardiyovasküler risk değerlendirmesinde yararlı olabilir.

Anahtar Kelimeler

• Parkinson hastalığı
• arteriyel sertlik
• nabız dalga hızı (NDH)
• D vitamini
• otonomik fonksiyon
• kardiyovasküler risk

Destekleyen Kurum

Bu çalışma herhangi bir kurum, kuruluş veya fon tarafından desteklenmemiştir.

Etik Beyan

Bu çalışma, Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür. Araştırma için gerekli etik kurul onayı S.B.Ü. Antalya Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu , 2019-035ile alınmıştır. Çalışmada kullanılan tüm veriler, ilgili kurumun veri gizliliği ve hasta mahremiyeti politikalarına uygun şekilde anonimleştirilmiştir. Hastalardan bilgilendirilmiş onam alınmış veya retrospektif veri kullanımı için ilgili mevzuat doğrultusunda onam gerekliliği etik kurul tarafından muaf tutulmuştur. Yazarlar, çalışmada herhangi bir çıkar çatışması bulunmadığını, araştırmanın bilimsel ve etik standartlara uygun şekilde yürütüldüğünü ve tüm sorumluluğu kabul ettiklerini beyan eder.

Association Between Vitamin D Levels and Arterial Stiffness in Parkinson’s Disease

Öz

Background: Parkinson’s disease (PD) is associated with non motor features including autonomic dysfunction; vascular aging and vitamin D deficiency may contribute to cardiovascular risk. We investigated relationships between brachial ankle pulse wave velocity (PWV), serum 25 hydroxyvitamin D [25(OH)D] and autonomic measures in PD. Methods: Ninety two PD patients and 73 age matched healthy controls were enrolled. All participants underwent wintertime serum 25(OH)D measurement and standardized PWV assessment. Univariate and multivariate linear regression models evaluated determinants of PWV including age, sex, mean arterial pressure (MAP), HbA1c, total cholesterol, BMI, triglycerides, vitamin D and PD status. Results: A total of 165 subjects were analyzed. PD patients had significantly lower 25(OH)D levels (median 15.00 vs 22.00 ng/mL, p<0.001) and higher PWV (median 8.50 vs 7.70 m/s, p=0.030) (Table 1). In multivariate Model 1 (R²=0.560), age (β≈0.70, p<0.001) and MAP (β≈0.16, p≈0.002–0.004) were independent predictors of PWV (Table 3). Vitamin D was not an independent predictor in the full model; inclusion of a VitD × PD interaction in Model 2 modestly increased explained variance (R²→0.571) and showed a borderline effect (B=0.048, p=0.056), suggesting a potential modifying role of vitamin D in PD that warrants further study. Conclusions: Arterial stiffness is increased in PD and is primarily associated with age and autonomic dysfunction. Lower vitamin D levels in PD and the borderline VitD×PD interaction provide a hypothesis for future prospective and interventional studies. baPWV may be useful for cardiovascular risk stratification in PD populations.

Anahtar Kelimeler

• Parkinson’s disease
• arterial stiffness
• pulse wave velocity
• vitamin D
• autonomic dysfunction
• cardiovascular risk

Destekleyen Kurum

This study did not receive any financial support from any institution, organization, or funding body.

Etik Beyan

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval for the research was obtained from the Clinical Research Ethics Committee of Antalya Training and Research Hospital (approval number: 2019-035). All data used in the study were anonymized in accordance with the institution’s data privacy and patient confidentiality policies. Informed consent was obtained from all patients, or, for the use of retrospective data, the requirement for informed consent was waived by the ethics committee in accordance with relevant regulations. The authors declare that there is no conflict of interest related to this study, that the research was conducted in compliance with scientific and ethical standards, and that they accept full responsibility for the content of the work.

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