Tabla I. Características basales en la población con enfermedad de Parkinson (n = 99). |
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Sexo |
Masculino |
67 (68%) |
Femenino |
32 (32%) |
|
Edad a |
66 (17) |
|
Años desde el diagnóstico a |
7 (8) |
|
Años de educación a |
10 (7) |
|
Subtipo motor de inicio |
Temblor |
60 (61%) |
Rigidez/bradicinesia |
32 (32%) |
|
Inestabilidad de la marcha |
6 (6%) |
|
Mixto |
1 (1%) |
|
Tabaquismo |
35 (35%) |
|
Tratamiento de la enfermedad de Parkinson |
Tratamiento con levodopa |
86 (87%) |
Otros tratamientos (agonistas, IMAO) |
13 (13%) |
|
Puntuación en la escala de Hoehn & Yahr |
0 |
2 (2%) |
1 |
11 (11%) |
|
2 |
45 (45%) |
|
3 |
32 (33%) |
|
4 |
9 (9%) |
|
5 |
0 |
|
Puntuación en la MDS-UPDRS a |
57 (58) |
|
Puntuación en la MoCA a |
25 (4) |
|
Puntuación en el PDQ-8 a |
28 (31) |
|
Puntuación en la PDSS-2 a |
14 (17) |
|
Puntuación en la NMSS a |
41 (55) |
|
IMAO: inhibidores de la monoaminooxidasa; MDS-UPDRS: escala unificada de la enfermedad de Parkinson modificada por la Sociedad de Trastornos del Movimiento; MoCA: escala de evaluación cognitiva de Montreal; NMSS: escala de síntomas no motores: PDQ-8: cuestionario de la enfermedad de Parkinson-8; PDSS-2: escala de sueño de la enfermedad de Parkinson-2. a Mediana (rango intercuartílico). |
Tabla II. Características sociodemográficas y clínicas basadas en criterios positivos de síndrome metabólico. |
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0-1 criterio cumplido |
2 criterios cumplidos |
Síndrome metabólico |
p |
||
Edad a |
66 (17) |
65 (16) |
56 (21) |
0,039 |
|
Sexo |
Masculino |
55 (70%) |
7 (64%) |
4 (50%) |
0,691 |
Femenino |
24 (30%) |
4 (36%) |
4 (50%) |
||
Años desde el diagnóstico a |
5 (6) |
11 (7) |
8 (8) |
0,014 |
|
Subtipo motor de inicio |
Temblor |
48 (60%) |
7 (63%) |
5 (63%) |
0,875 |
Rigidez |
26 (33%) |
3 (27%) |
3 (37%) |
||
Inestabilidad de la marcha |
4 (5%) |
1 (9%) |
0 |
||
Mixto |
1 (1%) |
0 |
0 |
||
Hoehn & Yahr |
1 |
9 (11%) |
1 (9%) |
1 (13%) |
0,511 |
2 |
37 (47%) |
6 (55%) |
3 (38%) |
||
3 |
27 (34%) |
3 (27%) |
2 (25%) |
||
4 |
6 (8%) |
1 (9%) |
2 (25%) |
||
Puntuación total en la MDS-UPDRS a |
62 (53) |
49 (21) |
75 (89) |
0,330 |
|
Puntuación en la MDS-UPDRS, parte II a |
12 (16) |
13 (13) |
19 (16) |
0,700 |
|
Puntuación en la MDS-UPDRS, parte III a |
35 (29) |
33 (13) |
43 (51) |
0,663 |
|
Puntuación en la MDS-UPDRS, parte IV a |
0 (4) |
2 (7) |
0 (10) |
0,684 |
|
Puntuación en el PDQ-8 a |
25 (31) |
16 (31) |
38 (22) |
0,063 |
|
Puntuación en la MoCA a |
25 (5) |
24 (6) |
26 (9) |
0,172 |
|
Puntuación en la PDSS-2 a |
14 (15) |
6 (16) |
26 (24) |
0,220 |
|
Puntuación en la NMSS a |
40 (51) |
17 (32) |
76 (208) |
0,009 |
|
MDS-UPDRS: escala unificada de la enfermedad de Parkinson modificada por la Sociedad de Trastornos del Movimiento; MoCA: escala de evaluación cognitiva de Montreal; NMSS: escala de síntomas no motores; PDQ-8: cuestionario de la enfermedad de Parkinson-8; PDSS-2: escala de sueño de la enfermedad de Parkinson-2. a Mediana (rango intercuartílico). |
Tabla III. Escala de síntomas no motores en pacientes con enfermedad de Parkinson (EP) y con o sin síndrome metabólico. |
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EP con síndrome metabólico (n = 8) |
EP sin síndrome metabólico (n = 91) |
p |
|
Cardiovascular a |
1 (3) |
1 (4) |
0,936 |
Sueño/fatiga a |
15 (25) |
8 (12) |
0,099 |
Estado de ánimo/apatía a |
14 (44) |
5 (13) |
0,023 |
Problemas perceptivos a |
0 (7) |
0 (0) |
0,027 |
Atención/memoria a |
2 (18) |
1,5 (5) |
0,065 |
Tracto gastrointestinal a |
8 (17) |
2 (8) |
0,042 |
Función urinaria a |
4 (14) |
2 (7) |
0,244 |
Función sexual a |
5 (21) |
0 (1) |
0,030 |
Miscelánea a |
9 (15,5) |
3,5 (12) |
0,047 |
Hiposmia a |
4 (9) |
0 (2) |
0,047 |
a Mediana (rango intercuartílico). |
Clinical features of metabolic syndrome in patients with Parkinson’s disease Introduction. Focus on the metabolic causes underlying dopaminergic cell loss in Parkinson’s disease (PD) has increased lately. Glucose imbalances have been shown to be present in patients with PD. A syndrome characterized principally by insulin resistance and glucose dysregulations is metabolic syndrome. Scarce literature has evaluated the relation between these two diseases. Aim. To determine the prevalence and clinical features of metabolic syndrome and its components in patients with PD. Patients and methods. We analyzed data from 99 patients with PD diagnosis. Scales that evaluate motor, non-motor, and cognitive function, as well as sleep disorders and quality of life were registered. Metabolic syndrome was diagnosed according to the World Health Organization criteria. Results. Metabolic syndrome was reported in 8% of the population. When subdividing patients based on positivity to metabolic syndrome criteria, no significant differences in motor and cognitive function, as well as quality of life and sleep disorders were observed between groups. However, patients with metabolic syndrome showed worse scores in Non-Motor Symptom Scale compared to patients without the syndrome, especially gastrointestinal, mood/apathy, sexual function, perceptual and miscellaneous symptoms. No significant differences in clinical correlates were observed when grouping patients based on which single metabolic syndrome component was present. Conclusion. Metabolic syndrome might have an effect on non-motor symptomatology in PD, as patients with metabolic syndrome showed worse scores in Non-Motor Symptom Scale. Key words. Cognition. Insulin resistance. Metabolic syndrome. Non-motor symptoms. Obesity. Parkinson’s disease. |