Objective: To study the body composition and resting metabolic rate in patients with PD and to compare with healthy controls, disease severity and among motor subtypes.

Background: Altered body composition, particularly weight loss in Parkinson’s disease (PD) is a frequently documented but inadequately understood manifestation. It carries significant clinical and prognostic implications. An increased resting metabolic rate (RMR) is found to be associated with the postural instability/Gait difficulty subtype of PD(1,2).

Method: An interim analysis of a prospective study of 392 patients with PD and 137 healthy controls from a tertiary care center in India. Detailed clinical evaluation was performed, including body composition measurements by Body Composition Monitor. The study is funded by Scientific Knowledge for Ageing and Neurological ailments-Research Trust (SKAN-RT).

Results: The demographic and clinical details of the patients and the controls are mentioned Table-1. Weight loss was reported in 50 patients (12.8%). PD patients were found to have a significantly lower body weight, BMI, body fat percentage, visceral fat percentage, abdominal girth, and a higher skeletal muscle percentage as compared to the control group (p<0.001). There was no statistically significant difference in the RMR between the two groups. Patients with dyskinesia (n=132) had significantly lower body weight, BMI, visceral fat percentage and abdominal girth than those without dyskinesia (n=260) (p<0.001). The RMR was found to be higher in patients without dyskinesia. There was no significant difference between the motor subtypes except for lower body weight in PIGD. Weight and body mass index showed a negative correlation with total duration of illness and MDS UPDRS-III scores in OFF medication states. Visceral fat percentage was found to be decreasing with an increase in the duration of illness and MDS-UPDRS-III OFF-medication scores. RMR was found to be decreasing with increasing duration of illness.

Conclusion: The lower body weight and fat percentage and a higher skeletal muscle percentage in patients with PD can be due to a negative energy balance, where energy expenditure exceeds intake, resulting in fat loss. This finding contradicts the concept of sarcopenic obesity. RMR was also surprisingly low in our patients as compared to healthy controls, which is contrary to the previous reports, prompting further studies with a larger cohort.

Table1:Comparison of PD and healthy controls

References: 1. Petroni ML, Albani G, Bicchiega V, Baudo S, Vinci C, Montesano A, et al. Body composition in advanced-stage Parkinson’s disease. Acta Diabetol. 2003 Oct;40 Suppl 1:S187-190.
2. Femat-Roldán G, Gaitán Palau MA, Castilla-Cortázar I, Elizondo Ochoa G, Moreno NG, Martín-Estal I, et al. Altered Body Composition and Increased Resting Metabolic Rate Associated with the Postural Instability/Gait Difficulty Parkinson’s Disease Subtype. Park Dis. 2020;2020:8060259.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/body-composition-and-resting-metabolic-rate-in-parkinsons-disease-a-cross-sectional-study/