Dietary Supplement Use is High among Individuals with Parkinson Disease

Association of 25-hydroxyvitamin D with Parkinson's disease based on the results from the NHANES 2007 to 2018 and Mendelian randomization analysis

An abundance of observational researches had suggested that vitamin D insufficient was related to Parkinson's disease (PD) risk. However, their relationships were debatable and the causality remains uncertain. We intended to evaluate the association between 25-hydroxyvitamin D [25(OH)D] and Parkinson's disease (PD) risk using NHANES data (2007-2018) and Mendelian randomization (MR) analyses with the genome-wide association study (GWAS) summary data. Demographic characteristics and multivariable-adjusted logistic regression were conducted to assess the relationship between the serum 25(OH)D levels and risk of PD prevalence by utilizing NHANES database. Besides, a two-sample MR analysis was applied to evaluate the causal association between serum 25(OH)D levels and PD risk. The main analysis was conducted by citing the inverse-variance-weighted (IVW) approach, while additional MR approaches and multiple sensitivity analysis were cited to evaluate the robustness and pleiotropy for the discoveries. In total, 30,796 adults from NHANES 2007-2018 were selected for the present research. As a result, 1.1% participants with PD (mean age: 61.9 ± 15.5 years), while 68.5% reported vitamin D insufficient. Compared with participants without PD, those with PD had a greater level of 25(OH)D (P < 0.01). However, after adjusted for demographic characteristics and comorbid factors, this association was not observed. Furthermore, no potential causal relationships between the serum level of 25(OH)D and PD risk were found via MR analysis (IVW-MR: OR = 1.082; 95% CI, 0.902 to 1.297; P = 0.395). After eliminating variants with horizontal pleiotropy risk, pleiotropy-robust MR analysis presented similar results. In conclusion, this research suggested that serum 25(OH)D levels was not correlated with PD risk. Additionally, the MR analyses revealed no significant causal association between serum 25(OH)D levels and PD risk at the genetic level. Awareness of these findings may improve personalized prevention and treatment of PD.

A systematic review of the potential consequences of abnormal serum levels of vitamin B6 in people living with Parkinson's disease

The prevalences of polyneuropathy and epilepsy are higher in people living with Parkinson's disease (PwPD) when compared to older adults. Vitamin B6 is widely available and affordable. PwPD are at higher risk of having abnormal serum levels of vitamin B6, which are associated with polyneuropathy and epilepsy that are potentially preventable and treatable. Potential contributors to abnormal B6 levels in PwPD include age, dietary habits, vitamin supplement misuse, gastrointestinal dysfunction and complex interactions with levodopa. The literature on the potential consequences of abnormal B6 levels in PwPD is limited by a small number of observational studies focused on polyneuropathy and epilepsy. Abnormal B6 levels have been reported in 60 of 145 PwPD (41.4% relative frequency). Low B6 levels were reported in 52 PwPD and high B6 levels were reported in 8 PwPD. There were 14 PwPD, polyneuropathy and low B6. There were 4 PwPD, polyneuropathy and high B6. There were 4 PwPD, epilepsy and low B6. Vitamin B6 level was low in 44.6% of PwPD receiving levodopa-carbidopa intestinal gel and in 30.1% of PwPD receiving oral levodopa-carbidopa. In almost all studies reporting low B6 in PwPD receiving oral levodopa-carbidopa, the dose of levodopa was ≥1000 mg/day. Rigorous epidemiological studies will clarify the prevalence, natural history and clinical relevance of abnormal serum levels of vitamin B6 in PwPD. These studies should account for diet, vitamin supplement use, gastrointestinal dysfunction, concurrent levels of vitamin B12, folate, homocysteine and methylmalonic acid, formulations and dosages of levodopa and other medications commonly used in PwPD.

Levodopa Content of Mucuna pruriens Supplements in the NIH Dietary Supplement Label Database

This case series assesses the levels of levodopa in Mucuna pruriens supplements available in the US that are included in the National Institutes of Health Dietary Supplement Label Database.

No Vitamin D Deficiency in Patients with Parkinson’s Disease

Previous trials describe a decrease of vitamin D levels in patients with Parkinson’s disease and relationships to clinical disease severity. This case control study found higher but not significant 25-OH-vitamin D plasma levels in patients with Parkinson’s disease compared with age- and sex-matched controls and no associations to clinical parameters, such as rating scores of disease severity or assessments of cognitive function. A certain variability of vitamin D concentrations was observed in both cohorts, which were investigated during the same season. These outcomes put into perspective the emerging discussion on the importance of vitamin D in Parkinson’s disease. Our results warrant further confirmatory research with a strict matching design of patients and controls, which has not been done in previous investigations. We stress that this case control study does not allow any comment on the putative beneficial effects of vitamin D supplementation, ie, on bone mass or bone mineral density, in patients with Parkinson’s disease.

Mucuna pruriens in Parkinson's and in some other diseases: recent advancement and future prospective

Mucuna pruriens (Mp) is an annual and perennial legume which belongs to the family Fabaceae having different types of therapeutic activity. Anti-oxidative, anti-inflammatory, anti-epileptic, anti-microbial, etc. are the example of some most common activities of Mp. It is widely utilized as a potent aphrodisiac. The anti-Parkinsonian activity of Mp was explored since the nineteenth century. The neuroprotective activity of Mp was shown by several researchers. Levodopa (L-DOPA) is the important constituents responsible for the anti-Parkinsonian activity of Mp. Apart from L-DOPA, several other important bioactive components like Ursolic acid (UA) and Betulinic acid (BA) also exhibit a similar neuroprotective activity. Parkinson's disease (PD) is mainly sporadic. A very small proportion shows the genetic nature of PD. The anti-Parkinsonian activity of Mp was explored in different toxin-induced PD models as like MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), Rotenone, Paraquat, 6-hydroxydopamine (6-OHDA) as suggested by several pieces of literature. Various parts of Mp's like seed, leaf, and stem exhibit potent neuroprotective attributes. Among different parts, seeds are widely utilized as anti-PD agents because of the higher percentage of L-DOPA. Besides anti-PD activity, Mp's neuroprotective potential was also explored in the ischemic model of stroke that also shows positive results. Recently, several clinical trials have been performed on the anti-PD activity of Mp on PD patients that show convincing results. Although, a small population-based study needs to be further validated in the broader population. Apart from anti-PD activity, Mp also shows its therapeutic activity in some other diseases like cancer, diabetes, skin infection, anemia, antihypertensive, etc. that are summarized in Table 1. In this review, we have discussed the anti-PD potential of Mp in the sporadic and genetic model along with some clinical trials that have performed on PD patients. Some other activity of Mp is also summarized in this review. There is a strong need to test the efficacy of Mp in some other neurodegenerative diseases along with PD. Following this, this review emphasizes the role of Mp in PD systematically through literature analysis available to date. [Table: see text].

Clinical correlates of serum 25-hydroxyvitamin D in Parkinson's disease

BACKGROUND

Parkinson's disease (PD) patients have lower levels of serum 25-hydroxyvitamin D (25(OH)D) than the general population. Previous studies have suggested a negative association between 25(OH)D and clinical features of PD, but the data are inconsistent.

MATERIALS AND METHODS

We conducted a cross-sectional, observational study. Serum 25(OH)D, disease (Hoehn-Yahr stage [HY]) and clinical symptom (Unified Parkinson Disease Rating Scale [UPDRS]) severity and global cognitive functions (Mini-Mental State Examination [MMSE]) were studied in 500 consecutive PD patients not using vitamin D supplements. Information on sunlight exposure and dietary intakes (using a 66-item food frequency questionnaire) were also collected. A convenient sample of age and sex-matched community healthy controls (N = 100) was included as a control group.

RESULTS

PD patients had lower 25(OH)D serum levels than controls. Deficiency status (<20 ng/mL) was found in 65.6% of patients. 25(OH)D levels were independently correlated to sunlight exposure (P = .002) and vitamin D intake (P = .009). In multivariate models, using a Mendelian randomization approach, lower serum 25(OH)D was associated with more severe disease (HY, P = .035), worse clinical symptoms (UPDRS Part-III total score [P = .006] and dopaminergic [P = .033] and non-dopaminergic subscores [P = .001]) and greater global cognitive function impairment (P = .041). Neither cognitive functions nor clinical features were associated with reduced intake of vitamin D and sunlight exposure.

CONCLUSION

: Serum 25(OH)D was negatively correlated with disease and symptoms severity, as well as with global cognitive functions. Our study adds to the evidence that low 25(OH)D may affect the progression of PD negatively. Intervention studies in this area are required.