Article

OBJECTIVE: : To determine the pathogenesis of the stooped posture in Parkinson
disease (PD), we prospectively studied fractures in a cohort of patients with
Parkinson disease for 5 yrs. DESIGN: : At baseline, we recorded the dietary
intake of vitamin D and serum concentrations of parathyroid hormone and
25-hydroxyvitamin D. Bone mineral density and lateral thoracic and lumbar spine
radiographs were obtained at baseline and every year for 5 yrs. RESULTS: : During
the 5-yr study period, stooped posture developed in 34 patients; the rest of the
58 patients did not show stooped posture. At baseline, mean serum
25-hydroxyvitamin D and parathyroid hormone levels were 10.9 ng/ml and 73.1
pg/ml, respectively, in the stooped group and 18.6 ng/ml and 56.4 pg/ml,
respectively, in the nonstooped group. Bone mineral density in the stooped group
was significantly lower than in the nonstooped group. Dietary intake of vitamin D
in the stooped group was significantly lower than in the nonstooped group. During
the study period, 19 (22%) patients in the nonstooped group developed new
vertebral fracture, compared with 23 (100%) patients in the stooped group. The
mean +/- SD percentage changes in bone mineral density were -6.5 +/- 0.6 in the
stooped group and -3.8 +/- 0.8 in the nonstooped group. Mean serum levels of
25-hydroxyvitamin D after 5 yrs were 7.0 ng/ml in the stooped group and 14.1
ng/ml in the nonstooped group. CONCLUSIONS: : Stooped posture in Parkinson
disease may be caused by vertebral fractures resulting from vitamin D deficiency
with compensatory hyperparathyroidism. Vitamin D supplementation may reduce
stooped posture in patients with Parkinson disease.

Langue : ANGLAIS