OBJECTIVE To determine whether being overweight or obese contributes to disease progression and functional status in Parkinson's disease (PD). DESIGN Cohort study using data from the Parkinson Progression Markers Initiative (PPMI). SETTING AND PARTICIPANTS A total of 399 drug-naive patients with early PD were classified into normal weight (body mass index of 18.5-24.9, n = 139), overweight (25.0-29.9, n = 167), and obese (30.0 or more, n = 93) groups. METHODS The primary outcome was the development of functional dependency. Functional dependency was defined as a Schwab and England score of less than 80% at any time point that remained throughout follow-up. The secondary outcomes were the changes in the Movement Disorders Society Unified Parkinson Disease Rating Scale motor score measured in the off-medication state and the Montreal Cognitive Assessment score across visits. RESULTS Over a 5-year follow-up period, the incidence of functional dependency was higher in the obese group than in the normal weight group (P = .001). No difference was observed between the overweight and normal weight groups (P = .429). The multivariable Cox model confirmed that obesity, but not overweight, increased the risk of dependency (hazard ratio 2.63, 95% confidence interval 1.32-5.23, P = .006). The increase in the Movement Disorders Society Unified Parkinson Disease Rating Scale motor score was greater in the obesity (P < .001) and overweight (P = .004) groups than in the normal weight group. Changes in the Montreal Cognitive Assessment score did not differ among the groups (P = .978). CONCLUSIONS AND IMPLICATIONS We found that obesity is related to an increased risk of functional dependency and rapid motor progression in patients with early PD. Although being overweight did not increase the risk of dependency, this condition was associated with rapid motor progression.

中文翻译：

---

超重和肥胖对早期帕金森病的功能和临床结果的影响

目的 确定超重或肥胖是否有助于帕金森病 (PD) 的疾病进展和功能状态。设计队列研究使用来自帕金森进展标志物倡议 (PPMI) 的数据。设置和参与者 共有 399 名早期 PD 初治患者被分为正常体重（体重指数 18.5-24.9，n = 139）、超重（25.0-29.9，n = 167）和肥胖（30.0 或更多） , n = 93) 组。方法 主要结果是功能依赖性的发展。功能依赖被定义为在整个随访期间保持的任何时间点 Schwab 和 England 评分低于 80%。次要结果是运动障碍协会统一帕金森病评定量表在停药状态下测量的运动评分的变化和访问期间的蒙特利尔认知评估评分。结果 在 5 年的随访期间，肥胖组的功能依赖性发生率高于正常体重组 (P = .001)。超重组和正常体重组之间没有观察到差异 (P = .429)。多变量 Cox 模型证实，肥胖而不是超重会增加依赖风险（风险比 2.63，95% 置信区间 1.32-5.23，P = .006）。运动障碍协会统一帕金森病评定量表运动评分在肥胖 (P < .001) 和超重 (P = .004) 组中的增幅高于正常体重组。蒙特利尔认知评估分数的变化在各组之间没有差异（P = .978）。结论和意义 我们发现肥胖与早期 PD 患者的功能依赖性和快速运动进展的风险增加有关。虽然超重不会增加依赖的风险，但这种情况与快速运动进展有关。