Predictors of weight loss in early treated Parkinson’s disease from the NET-PD LS-1 cohort
Weight loss is a common symptom of Parkinson’s disease and is associated with impaired quality of life. Predictors of weight loss have not been studied in large clinical cohorts. We previously observed an association between change in body mass index and change in Unified Parkinson’s Disease Rating Scale (UPDRS) motor and total scores. In this study, we performed a secondary analysis of longitudinal data (1–6 years) from 1619 participants in the NINDS Exploratory Trials in PD Long-term Study-1 (NET-PD LS1) to explore predictors of weight loss in a large prospective clinical trial cohort of early treated Parkinson’s disease. The NET-PD LS1 study was a double-blind randomized placebo controlled clinical trial of creatine monohydrate 10 gm/day in early treated PD (within 5 years of diagnosis and within 2 years of starting dopaminergic medications). Linear mixed models were used to estimate the effect of baseline clinical covariates on weight change over time. On average, participants lost only 0.6 kg per year. Higher age, baseline weight, female gender, higher baseline UPDRS scores, greater postural instability, difficulty eating and drinking, lower cognitive scores and baseline levodopa use (compared to dopamine agonists) were all associated with weight loss. Surprisingly baseline difficulty swallowing, dyskinesia, depression, intestinal hypomotility (constipation) and self-reported nausea/vomiting/anorexia were not significantly associated with weight loss in this cohort of early treated Parkinson’s disease patients. On average, participants with Parkinson’s disease experience little weight loss during the first 1–6 years after starting dopaminergic replacement therapy, however levodopa use and postural instability were both predictors of early weight loss.
Trial Registration clinicaltrials.gov identifier# NCT00449865.
KeywordsBMI Weight loss Dysphagia Nausea Parkinson’s disease
The authors thank the patients and families who participate in the NET-PD LS-1 study. The following additional NINDS grants supported the Net-PD LS-1 study: U01NS043127, U01NS043128, and U10NS44415-44555 from the National Institute of Neurologic Disorders and Stroke. The funding agencies did not participate in the design or conduct of the study; collection, management, analysis, interpretation of the data; or preparation, review, or approval of the manuscript. Drs. Wills, Pérez, and Ruosha Li had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
RL carried out data management, statistical programming and biostatistical analysis. RL and AP both carried out the biostatistical analysis.
Compliance with ethical standards
Dr. Wills has received research support from the NIH, the MDA, ALSA, has consulting agreements with Accordant, a CVS/Caremark disease management company and with Sage Bionetworks and has participated in clinical trials funded by Merck, Acorda and Pfizer. Dr. Pérez reports NIH grants and Texas Department of State and Human Services grants. Ruosha Li and Xuehan Ren report grants from the NIH. Dr. Boyd served as a consultant and/or scientific advisor for AbbVie, Auspex, Teva, Lundbeck, Chronos Therapeutics, Neurocrine, and Medical Education Resources. He has received research support from the Michael J. Fox Foundation for Parkinson Research, NIH/NINDS, Auspex, Biotie, CHDI Foundation, Vaccinex, Teva, AbbVie, NeuroDerm, and Roche.
Conflicts of interest
The authors declare no conflicts of interest.
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