Altered Body Composition and Increased Resting Metabolic Rate Associated with the Postural Instability/Gait Difficulty Parkinson’s Disease Subtype

Abstract

Background. Weight loss in Parkinson’s disease (PD) patients is a common but poorly understood manifestation. Several studies have reported that weight changes could be related to motor symptoms, drug side effects, dysphagia, depression, and/or dementia. Weight loss in PD is not a benign phenomenon and it has several clinical and prognostic implications with increased morbidity and mortality. Thus, it is crucial to determine nutritional changes in PD patients in order to prevent malnutrition and improve their quality of life. Objective. To compare body composition and resting metabolic rates between PD patients and controls. Methods. A total of 64 PD patients and 52 controls were studied. The Hoehn-Yahr scale was used to determine the disease stage, clinical and epidemiological data were recorded from verbal questionnaire, Inbody S10® was used to collect corporal parameters, and FitMate system was used to assess the resting metabolic rate. Results. No significant differences were found between both experimental groups in age, gender, height, cholesterol levels, and the presence of hypertension, diabetes, and hypo/hyperthyroidism. However, the PD group showed lower body fat mass, whole-body fat percentage, and greater resting metabolic rate compared to controls (p<0.05), with no significant differences in musculoskeletal mass. Parkinson’s disease postural instability/gait difficulty (PD-PIGD) subtype showed lower body fat parameters, increased fat-free mass, and higher resting metabolic rates. Conclusions. These results suggest that PD patients present an increased resting metabolic rate associated with the postural instability/gait difficulty PD subtype, allowing a selective decrease of body fat mass and not musculoskeletal mass. Of note, several disease-related factors may contribute to this weight loss in PD patients, being a complex and multifactorial consequence. Our findings could likely be one of the many contributing factors. However, present findings may further add to our understanding of the phenomenon of weight loss in patients with PD.

The Impact of Dietary Intake and Physical Activity on Body Composition in Parkinson's Disease

“…Overall, after adjusting for several confounders, females with PD, with low energy intake and low physical activity, were at higher risk for skeletal muscle wasting. Of note, when we compared weight between PD and family members, we did not find any statistical difference in agreement with previous studies 28–30 . In contrast, longitudinal studies have observed decreases and increases of weight in PD patients over time 4,31–33 .…”

A randomized feasibility trial of medium chain triglyceride-supplemented ketogenic diet in people with Parkinson's disease

“…The modest reduction in resting energy expenditure in PD from 2–3 weeks of a KD of approximately 100 kcal is a novel finding. This may be interesting to track in a future study to assess whether it is correlated with PD symptoms, as, for instance, a prior study showed an elevated metabolic rate in the postural instability/gait disorder subtype [ 61 ].…”

Constructing Prediction Models for Freezing of Gait by Nomogram and Machine Learning: A Longitudinal Study

“…A 5-year follow-up study found that weight loss heightened the risk of dependency and dementia, leading to poor prognosis ( 43 ), also, dementia was a risk factor of FOG ( 15 ). Patients with PD with the PIGD subtype had higher resting metabolic rates and lower body fat, which means patients with the PIGD subtype may more likely to experience weight change ( 44 ), and PIGD was identified as a possible risk factor for FOG. What is more, unexplained weight change especially weight loss was correlated with non-dopaminergic symptoms such as gait and balance disorders ( 45 ).…”