title: Vitamin d deficiency-induced vertebral fractures may cause stooped posture in Parkinson disease.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurology, Mitate Hospital, Tagawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sato
authors.forename: Jun
authors.initials: J
authors.lastname: Iwamoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Honda
mesh_terms: D000368:Aged; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010300:Parkinson Disease / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D011187:Posture; D016103:Spinal Fractures / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D013904:Thoracic Vertebrae / Q000293:injuries*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000150:complications* / Q000378:metabolism / Q000473:pathology
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D