Is insulin resistance associated with fatigue, the severity of the disease and motor disability in idiopathic Parkinson’s disease?

Yıl 2019, , 437 - 440, 28.06.2019

Gökhan Özer , Hatice Adıgüzel Zekiye İpek Katırcı Kırmacı , Nevin Ergun

https://doi.org/10.28982/josam.521927

Öz

Aim: Abnormal glucose metabolism is known to potentially correlate abnormal mitochondrial function and neurodegenerative processes. The purpose of the study was to determine the association of insulin resistance on fatigue, the severity of the disease and motor disability in patients with idiopathic Parkinson’s disease (IPD).

Methods: A total of 50 patients diagnosed with IPD by a neurologist from university hospital were enrolled to study. Demographic characteristics (age, gender, height, weight and body mass index (BMI) were recorded. Patients were allocated into two groups by insulin resistance (IR), named insulin resistance (+) as group 1 (IR+) (n=30 (10 female, 20 male), age=66 years, height=169 cm, weight=75 kg, BMI=26.6 kg/m2 (median)) and insulin resistance (-) as group 2 (IR-) (n=20 (8 female, 12 male), age=63.5 years, height=168 cm, weight=75 kg, BMI=26.95 kg/m2 (median)). The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) test was used for assessment of insulin resistance. The disease severity was assessed by the Modified Hoehn and Yahr Scale, motor disability was assessed by Movement Disorders Society-revised Unified PD Rating Scale (MDS-UPDRS) and fatigue was rated by Fatigue Severity Scale (FSS). 

Results: MDS-UPDRS scores were statistically significantly different between the groups of IPD patients with IR(+) and IR(-) (P=0.034). Modified Hoehn - Yahr (P=0.300) and FSS (P=0.147) scores were not statistically significantly different between the same groups.

Conclusion: This study suggests that IR may have a role for disease severity in patients with IPD. In patients with IPD, insulin resistance should be questioned and considered in the treatment and rehabilitation program.

Anahtar Kelimeler

Fatigue, Idiopathic Parkinson’s disease, Insulin resistance, Motor disability

İdiopatik Parkinson hastalığında insülin direnci yorgunluk, hastalık şiddeti ve motor yetersizlik ile ilişkili midir?

Öz

Amaç: Anormal glukoz metabolizmasının, anormal mitokondriyal fonksiyon ve nörodejeneratif süreçler ile potansiyel olarak ilişkili olduğu bilinmektedir. Çalışmanın amacı idiopatik Parkinson hastalığı (İPH) olan hastalarda insulin direnci ile yorgunluk, hastalık şiddeti ve motor yetersizlik ile ilişkisini incelemektir. 

Yöntemler: Çalışmaya üniversite hastanesine başvuran ve nörolog tarafından İPH tanısı alan toplam 50 hasta alındı. Hastaların demografik özellikleri (yaş, cinsiyet, boy, kilo, vücut kitle indeksi (VKİ) kaydedildi. Hastalar insulin direnci (IR) olup olmamasına göre iki gruba ayrıldı. İnsülin direnci olan grup, grup 1 (IR+) (n=30 (10 kadın, 20 erkek, yaş= 66, boy=169 cm, kilo=75 kg, VKI=26,6 kg/m2 (medyan)), insulin direnci olmayan grup, grup 2 (IR-) (n=20 (8 kadın, 12 erkek, yaş=63,5, boy=168 cm, kilo=75 kg, VKI=26,95 kg/m2 (medyan)). İnsülin direncinin değerlendirilmesi için Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) testi yapıldı. Hastalık şiddeti Modified Hoehn-Yahr skalası ile, motor yetersizlik Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (MDS-UPDRS) skalası ile, yorgunluk ise Yorgunluk Etki Ölçeği ile değerlendirildi. 

Bulgular: MDS-UPDRS skorları IR (+) ve IR (-) olan İPH hasta grupları arasında istatistiksel olarak anlamlı farklılık gösterdi (P=0,034). Modifiye Hoehn - Yahr (P=0,300) ve FSS (P=0,147) skorları açısından gruplar arasında istatistiksel olarak anlamlı farklılık bulunmadı. 

Sonuç: Bu çalışma, İPH hastalarında IR'nin hastalık şiddeti için bir rolü olabileceğini düşündürmektedir. İPH'li hastalarda insülin direnci sorgulanmalı ve tedavi ve rehabilitasyon programında düşünülmelidir.

Anahtar Kelimeler

İnsülin direnci, Yorgunluk, Motor yetersizlik, İdiopatik Parkinson hastalığı

Kaynakça

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