The Role of Metabo-Inflammatory Syndrome and Ferropathological Processes in Atherosclerotic Plaque Formation in Parkinson's Disease: Insights from High-Resolution Carotid Duplex Analysis.

Abstract

Objective: Peripheral metabo-inflammatory disturbances and ferropathological processes are closely linked to steno-occlusive pathologies in Parkinson's disease (PD), though their roles remain to be fully elucidated. This study aims to investigate cardio-metabolic risk stratification in PD in the context of peripheral metabo-inflammatory and ferropathological abnormalities, and to analyze the role of iron-related dysregulation in carotid atherosclerosis.

Method: This cross-sectional case-control study employed high-resolution carotid duplex imaging. Risk stratification for metabolic syndrome (MetS) was assessed using lipid-to-high-density lipoprotein cholesterol (HDL-C) ratios. Intercorrelative and multinomial regression analyses were performed for statistical comparison.

Results: PD patients showed a higher tendency toward cardiovascular disease (CVD) and atherogenicity. Calcified plaque formation and Type 4 stenosis patterns were significantly more prevalent (χ2 = 21.717, χ2 = 60.609; P < 0.001), along with altered peripheral iron correlation profiles in PD. An increased risk for MetS was also observed (cholesterol/HDL-C (P = 0.015 (z = 2.434), triglyceride/HDL-C ratio (P = 0.013 (z = 2.471)), along with augmented inflammatory hematological ratios in PD. In multinomial regression analysis, a 1-unit increase in glycated hemoglobin (HbA1c) was associated with a 1.967-fold increase in the likelihood of plaque-forming classification (Odds Ratio = 1.967). Additionally, a 1-unit increase in low-density lipoprotein cholesterol was associated with a slight decrease in risk (Odds Ratio = 0.981) (Cox-Snell = 0.266, Nagelkerke = 0.294).

Conclusion: Patients with PD demonstrated a higher risk of CVD and atherosclerotic plaque complications. A close association was observed between MetS and elevated cholesterol/HDL-C and triglyceride/HDL-C ratios. Additionally, there was an increased risk of oxidative stress-related atherothrombotic complications, driven by heightened inflammatory ratios and disturbed ferropathologic processes. However, peripheral iron disturbances did not show a significant relationship with stenosis patterns.