Association between non-motor symptoms of Parkinson disease and serum lipid levels: Analysis and clinical significance

Abstract

This study investigates the association between non-motor symptoms (NMS) and serum lipid levels in patients with Parkinson disease (PD), and analyzes their potential clinical significance. A retrospective study was conducted, collecting data from 116 PD patients hospitalized at a certain hospital from February 2021 to January 2024. According to the total score of the NMS Scale, patients were divided into a mild NMS group (<41 points, n = 54) and a severe NMS group (≥41 points, n = 62). General clinical data, non-motor symptom scores (including Montreal Cognitive Assessment, Hamilton Depression Scale, Hamilton Anxiety Scale, Parkinson Disease Sleep Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, King Parkinson Disease Pain Scale, Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction, etc), and serum lipid parameters (including total cholesterol [TC], triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], apolipoprotein A1 [ApoA1], apolipoprotein B, etc) were collected. Spearman correlation analysis and multiple linear regression were used to explore the correlations between lipid parameters and non-motor symptom scores. Compared with the mild NMS group, patients in the severe NMS group had significantly lower levels of TC, LDL-C, and ApoA1 (all P < .05). Serum lipid levels were generally positively correlated with cognitive function (e.g., ApoA1 and Montreal Cognitive Assessment: R = 0.26, P = .007), and negatively correlated with depression and anxiety scores (e.g., ApoA1 and Hamilton Depression Scale: R = -0.29, P = .003). Additionally, certain lipid parameters such as HDL-C and ApoA1 were positively correlated with sleep quality (Parkinson Disease Sleep Scale), and negatively correlated with autonomic dysfunction (Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction [SCOPA-AUT]), pain (King Parkinson Disease Pain Scale), and fatigue (Fatigue Severity Scale), suggesting that higher lipid levels are associated with milder NMS manifestations. Triglycerides, the TC/HDL-C ratio, and the LDL-C/HDL-C ratio showed no significant correlations. Serum lipid levels in PD patients, especially TC, LDL-C, HDL-C, and ApoA1, are closely associated with various NMS and may play a protective role in the occurrence and progression of NMS. Lipid levels may have potential as biomarker candidates for risk assessment and management of NMS in PD, warranting further investigation.

Keywords: ApoA1; Parkinson disease; autonomic dysfunction; cognitive function; depression; non-motor symptoms; serum lipids.