Exploring the relationships between clinical manifestations and sex hormones, thyroid hormones, and menstrual factors in female Parkinson's disease patients.

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Frontiers in Medicine Pub Date : 2025-09-24 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1573768
Fan Wang, Jing Zhao, Jichen Du, Jilai Li, Peifu Wang, Zhong Yi, Tao Feng, Zhirong Wan
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Six sex hormones and seven thyroid function indicators were measured, followed by an analysis of the relationships among sex hormone levels, thyroid function, menstrual factors, clinical characteristics, and disease severity in PWP. The effects of sex hormones and menstrual factors on motor complications in PWP were also investigated.</p><p><strong>Results: </strong>The results revealed several key findings: (1) PWP-MC exhibited lower serum prolactin levels than PWP-nMC (<i>p</i> < 0.05). (2) In PWP, serum estradiol levels were negatively correlated with Hamilton Anxiety Rating Scale (HAMA) scores (<i>r</i> = -0.208, <i>p</i> = 0.043). (3) There were no statistically significant differences in age at menarche, age at menopause, menstrual cycle duration, menstruation duration (Days of active bleeding per cycle), or total years of menstruation between PWP-MC and PWP-nMC (<i>p</i> > 0.05). (4) In PWP, age at menarche was negatively correlated with Mini-Mental State Examination (MMSE) scale scores (<i>r</i> = -0.264, <i>p</i> = 0.01) and Montreal Cognitive Assessment (MoCA) scale scores (<i>r</i> = -0.297, <i>p</i> = 0.004); total years of menstruation were positively correlated with MoCA scale scores (<i>r</i> = 0.278, <i>p</i> = 0.006); menstrual cycle duration was negatively correlated with Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) scores (<i>r</i> = -0.246, <i>p</i> = 0.016) and Hoehn-Yahr (H-Y) stages (<i>r</i> = -0.236, <i>p</i> = 0.021); and menstruation duration was positively correlated with HAMA (<i>r</i> = 0.215, <i>p</i> = 0.036) and Non-Motor Symptoms Scale (NMSS) scores (<i>r</i> = 0.214, <i>p</i> = 0.037). (5) In PWP-MC, age at menopause and total years of menstruation were positively correlated with Hamilton Depression Rating Scale (HAMD) scores (<i>r</i> = 0.335, <i>p</i> = 0.043; <i>r</i> = 0.352, <i>p</i> = 0.033, respectively); menstruation duration was negatively correlated with UPDRS-III scores (<i>r</i> = -0.362, <i>p</i> = 0.028) and positively correlated with HAMD (<i>r</i> = 0.329, <i>p</i> = 0.047) and HAMA (<i>r</i> = 0.451, <i>p</i> = 0.005) scores; and menstruation duration was positively correlated with NMSS (<i>r</i> = 0.325, <i>p</i> = 0.050) scores. (6) In PWP-nMC, age at menarche was negatively correlated with MMSE (<i>r</i> = -0.332, <i>p</i> = 0.011) and MoCA (<i>r</i> = -0.296, <i>p</i> = 0.024) scores; total years of menstruation were negatively correlated with UPDRS-III (<i>r</i> = -0.287, <i>p</i> = 0.029) scores and positively correlated with MMSE (<i>r</i> = 0.316, <i>p</i> = 0.016) and MoCA (<i>r</i> = 0.337, <i>p</i> = 0.010) scores. (7) Compared with PWP-nMC, PWP-MC had lower serum triiodothyronine levels (<i>p</i> < 0.05) and higher serum thyroid-stimulating hormone levels (<i>p</i> < 0.05). (8) In PWP-MC, triiodothyronine levels were negatively correlated with UPDRS-III scores (<i>r</i> = -0.344, <i>p</i> = 0.037) and H-Y stages (<i>r</i> = -0.445, <i>p</i> = 0.005); free triiodothyronine (FT3) levels were negatively correlated with H-Y stages (<i>r</i> = -0.476, <i>p</i> = 0.003); and free thyroxine (FT4) levels were negatively correlated with UPDRS-III scores (<i>r</i> = -0.422, <i>p</i> = 0.009) and H-Y stages (<i>r</i> = -0.365, <i>p</i> = 0.026).</p><p><strong>Conclusion: </strong>These findings suggest that the occurrence of motor complications in PWP may be correlated with prolactin, T3, and FT3 levels. 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引用次数: 0

Abstract

Background: Parkinson's disease (PD) affects both sexes, but there are notable differences in its clinical manifestations and management in women.

Objective: This study aimed to compare variations in sex and thyroid hormone levels and menstrual factors between postmenopausal women with and without motor complications (PWP-MC and PWP-nMC, respectively) and analyze their correlations with motor complications.

Methods: Ninety-five Postmenopausal Women with Parkinson's Disease (PWP) provided data on age at menarche, age at menopause, menstrual cycle duration (interval between cycle starts (days)), total years of menstruation (menopausal age - age at menarche), thyroid disease history, and gynecological surgical history. Six sex hormones and seven thyroid function indicators were measured, followed by an analysis of the relationships among sex hormone levels, thyroid function, menstrual factors, clinical characteristics, and disease severity in PWP. The effects of sex hormones and menstrual factors on motor complications in PWP were also investigated.

Results: The results revealed several key findings: (1) PWP-MC exhibited lower serum prolactin levels than PWP-nMC (p < 0.05). (2) In PWP, serum estradiol levels were negatively correlated with Hamilton Anxiety Rating Scale (HAMA) scores (r = -0.208, p = 0.043). (3) There were no statistically significant differences in age at menarche, age at menopause, menstrual cycle duration, menstruation duration (Days of active bleeding per cycle), or total years of menstruation between PWP-MC and PWP-nMC (p > 0.05). (4) In PWP, age at menarche was negatively correlated with Mini-Mental State Examination (MMSE) scale scores (r = -0.264, p = 0.01) and Montreal Cognitive Assessment (MoCA) scale scores (r = -0.297, p = 0.004); total years of menstruation were positively correlated with MoCA scale scores (r = 0.278, p = 0.006); menstrual cycle duration was negatively correlated with Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) scores (r = -0.246, p = 0.016) and Hoehn-Yahr (H-Y) stages (r = -0.236, p = 0.021); and menstruation duration was positively correlated with HAMA (r = 0.215, p = 0.036) and Non-Motor Symptoms Scale (NMSS) scores (r = 0.214, p = 0.037). (5) In PWP-MC, age at menopause and total years of menstruation were positively correlated with Hamilton Depression Rating Scale (HAMD) scores (r = 0.335, p = 0.043; r = 0.352, p = 0.033, respectively); menstruation duration was negatively correlated with UPDRS-III scores (r = -0.362, p = 0.028) and positively correlated with HAMD (r = 0.329, p = 0.047) and HAMA (r = 0.451, p = 0.005) scores; and menstruation duration was positively correlated with NMSS (r = 0.325, p = 0.050) scores. (6) In PWP-nMC, age at menarche was negatively correlated with MMSE (r = -0.332, p = 0.011) and MoCA (r = -0.296, p = 0.024) scores; total years of menstruation were negatively correlated with UPDRS-III (r = -0.287, p = 0.029) scores and positively correlated with MMSE (r = 0.316, p = 0.016) and MoCA (r = 0.337, p = 0.010) scores. (7) Compared with PWP-nMC, PWP-MC had lower serum triiodothyronine levels (p < 0.05) and higher serum thyroid-stimulating hormone levels (p < 0.05). (8) In PWP-MC, triiodothyronine levels were negatively correlated with UPDRS-III scores (r = -0.344, p = 0.037) and H-Y stages (r = -0.445, p = 0.005); free triiodothyronine (FT3) levels were negatively correlated with H-Y stages (r = -0.476, p = 0.003); and free thyroxine (FT4) levels were negatively correlated with UPDRS-III scores (r = -0.422, p = 0.009) and H-Y stages (r = -0.365, p = 0.026).

Conclusion: These findings suggest that the occurrence of motor complications in PWP may be correlated with prolactin, T3, and FT3 levels. Additionally, attention should be given to thyroid function and serum T3, T4, FT3, and FT4 levels in PWP, as lower levels may be associated with more severe motor symptoms, higher H-Y stages, and poorer cognitive function. Furthermore, older age at onset was inversely associated with motor complications in PWP, whereas a longer disease duration and higher NMSS score are risk factors.

探讨女性帕金森病患者临床表现与性激素、甲状腺激素及月经因素的关系。
背景:帕金森病(PD)男女皆可发病,但女性的临床表现和治疗存在显著差异。目的:比较绝经后有和无运动并发症(分别为PWP-MC和PWP-nMC)妇女的性别、甲状腺激素水平和月经因素的变化,并分析其与运动并发症的相关性。方法:95名绝经后帕金森病患者(PWP)提供了月经初潮年龄、绝经年龄、月经周期持续时间(周期开始间隔(天))、月经总年数(绝经年龄-月经初潮年龄)、甲状腺疾病史和妇科手术史等资料。测量6项性激素和7项甲状腺功能指标,分析PWP患者性激素水平与甲状腺功能、月经因素、临床特征和疾病严重程度之间的关系。探讨性激素和月经因素对PWP患者运动并发症的影响。结果:(1)PWP-MC血清催乳素水平低于PWP-nMC (p < 0.05)。(2) PWP患者血清雌二醇水平与汉密尔顿焦虑评定量表(HAMA)评分呈负相关(r = -0.208, p = 0.043)。(3) PWP-MC组与PWP-nMC组在月经初潮年龄、绝经年龄、月经周期、月经持续时间(每周期活动性出血天数)、月经总年数方面差异均无统计学意义(p < 0.05)。(4) PWP患者月经初潮年龄与MMSE评分(r = -0.264, p = 0.01)、MoCA评分(r = -0.297, p = 0.004)呈负相关;月经总年数与MoCA量表得分呈正相关(r = 0.278, p = 0.006);月经周期持续时间与统一帕金森病评定量表第三部分(UPDRS-III)评分(r = -0.246, p = 0.016)和Hoehn-Yahr (H-Y)分期(r = -0.236, p = 0.021)呈负相关;月经持续时间与HAMA评分(r = 0.215, p = 0.036)和NMSS评分(r = 0.214, p = 0.037)呈正相关。(5) PWP-MC患者的绝经年龄、月经总年数与汉密尔顿抑郁评定量表(HAMD)评分呈正相关(r = 0.335, p = 0.043; r = 0.352, p = 0.033);月经持续时间与UPDRS-III评分负相关(r = -0.362, p = 0.028),与HAMD评分正相关(r = 0.329, p = 0.047)、HAMA评分正相关(r = 0.451, p = 0.005);月经持续时间与NMSS评分呈正相关(r = 0.325, p = 0.050)。(6) PWP-nMC患者月经初潮年龄与MMSE (r = -0.332, p = 0.011)、MoCA (r = -0.296, p = 0.024)评分呈负相关;月经总年数与UPDRS-III评分呈负相关(r = -0.287, p = 0.029),与MMSE评分呈正相关(r = 0.316, p = 0.016),与MoCA评分呈正相关(r = 0.337, p = 0.010)。(7)与PWP-nMC相比,PWP-MC血清三碘甲状腺原氨酸水平较低(p < 0.05),血清促甲状腺激素水平较高(p < 0.05)。(8) PWP-MC患者三碘甲状腺原氨酸水平与updr - iii评分(r = -0.344, p = 0.037)和H-Y分期(r = -0.445, p = 0.005)呈负相关;游离三碘甲状腺原氨酸(FT3)水平与H-Y分期呈负相关(r = -0.476, p = 0.003);游离甲状腺素(FT4)水平与UPDRS-III评分(r = -0.422, p = 0.009)和H-Y分期(r = -0.365, p = 0.026)呈负相关。结论:PWP患者运动并发症的发生可能与泌乳素、T3、FT3水平有关。此外,应注意PWP患者的甲状腺功能和血清T3、T4、FT3和FT4水平,因为较低的水平可能与更严重的运动症状、更高的H-Y分期和更差的认知功能相关。此外,发病年龄较大与PWP的运动并发症呈负相关,而病程较长和NMSS评分较高是危险因素。
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来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
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