Unrecognized vitamin D3 deficiency is common in Parkinson disease: Harvard Biomarker Study.
OBJECTIVE
To conclusively test for a specific association between the biological marker 25-hydroxy-vitamin D3, a transcriptionally active hormone produced in human skin and liver, and the prevalence and severity of Parkinson disease (PD).


METHODS
We used liquid chromatography/tandem mass spectrometry to establish an association specifically between deficiency of 25-hydroxy-vitamin D3 and PD in a cross-sectional and longitudinal case-control study of 388 patients (mean Hoehn and Yahr stage of 2.1 ± 0.6) and 283 control subjects free of neurologic disease nested in the Harvard Biomarker Study.


RESULTS
Plasma levels of 25-hydroxy-vitamin D3 were associated with PD in both univariate and multivariate analyses with p values = 0.0034 and 0.047, respectively. Total 25-hydroxy-vitamin D levels, the traditional composite measure of endogenous and exogenous vitamin D, were deficient in 17.6% of patients with PD compared with 9.3% of controls. Low 25-hydroxy-vitamin D3 as well as total 25-hydroxy-vitamin D levels were correlated with higher total Unified Parkinson's Disease Rating Scale scores at baseline and during follow-up.


CONCLUSIONS
Our study reveals an association between 25-hydroxy-vitamin D3 and PD and suggests that thousands of patients with PD in North America alone may be vitamin D-deficient. This finding has immediate relevance for individual patients at risk of falls as well as public health, and warrants further investigation into the mechanism underlying this association.
From the Neurogenomics Laboratory (H.D., K.D., K.C.L., A.N.H., K.D., A.T.-L., C.R.S.), Harvard Medical School and Brigham & Women's Hospital, Cambridge; Biomarkers Program (K.D., K.C.L., A.N.H., K.D., A.T.-L., M.T.H., U.S.S., B.M., N.M., V.K., S.N.G., D.J.S., M.A.S., M.G.S., B.T.H., J.H.G., C.R.S.), Harvard NeuroDiscovery Center, Boston; Department of Neurology (J.J.L., U.S.S., A.-M.W., A.W.F., A.Y.H., N.M., V.K., S.N.G., M.A.S., B.T.H., J.H.G., C.R.S.), Massachusetts General Hospital, Boston; Department of Neurology (M.T.H., A.Y.H., D.J.S., L.R.S., C.R.S.), Brigham and Women's Hospital, Boston, MA; Paracelsus-Elena-Klinik (B.M.), Kassel, Germany; and Division of Neurology, the Ottawa Hospital, University of Ottawa (M.G.S.), Canada.
Hongliu
H
Ding
Kaltra
K
Dhima
Kaitlin C
KC
Lockhart
Joseph J
JJ
Locascio
Ashley N
AN
Hoesing
Karen
K
Duong
Ana
A
Trisini-Lipsanopoulos
Michael T
MT
Hayes
U Shivraj
US
Sohur
Anne-Marie
AM
Wills
Brit
B
Mollenhauer
Alice W
AW
Flaherty
Albert Y
AY
Hung
Nicte
N
Mejia
Vikram
V
Khurana
Stephen N
SN
Gomperts
Dennis J
DJ
Selkoe
Michael A
MA
Schwarzschild
Michael G
MG
Schlossmacher
Bradley T
BT
Hyman
Lewis R
LR
Sudarsky
John H
JH
Growdon
Clemens R
CR
Scherzer
D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D002762:Cholecalciferol / Q000172:deficiency*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000209:etiology* / Q000378:metabolism*; D015995:Prevalence; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000150:complications* / Q000175:diagnosis
D015415:Biomarkers; D002762:Cholecalciferol