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Post of the Week: Slightly Higher Cholesterol and Progression of PD


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#1 Dr. Okun

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Posted 20 August 2011 - 08:42 AM

Dear Forum Members,

This paper is a large subanalysis from the DATATOP paper (published in the early 90's). They looked at blood samples and found there may be a slighly slower progression in PD with moderately higher cholesterol. We do not recommend eating poorly to try to raise your cholesterol as this was a retrospective study and should not alter treatment. We do think this data may offer some clues about the pathogenesis and progression of PD. Here is the abstract published:

PLoS One. 2011;6(8):e22854. Epub 2011 Aug 11.
Serum Cholesterol and the Progression of Parkinson's Disease: Results from DATATOP.
Huang X, Auinger P, Eberly S, Oakes D, Schwarzschild M, Ascherio A, Mailman R, Chen H; for the Parkinson Study Group DATATOP Investigators.
Source
Departments of Neurology, Neurosurgery, Pharmacology, Radiology, and Kinesiology, Pennsylvania State University-Milton Hershey Medical Center, Hershey, Pennsylvania, United States of America.
Abstract
BACKGROUND:
Recent studies have suggested that higher serum cholesterol may be associated with lower occurrence of Parkinson's disease (PD). This study is to test the hypothesis that higher serum cholesterol correlates with slower PD progression.

METHODS:
Baseline non-fasting serum total cholesterol was measured in 774 of the 800 subjects with early PD enrolled between 1987 and 1988 in the Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP) trial. Participants were followed for up to two years, with clinical disability requiring levodopa therapy as the primary endpoint. Hazard ratios (HRs) and 95% confidence intervals (CI) were determined for increasing serum cholesterol concentration (in quintiles) for clinical disability requiring levodopa therapy, after adjusting for confounders. At baseline, only nine subjects reported use of cholesterol-lowering agents (two with statins).

RESULTS:
The overall mean cholesterol level was 216 mg/dL (range 100-355). The HR of progressing to the primary endpoint decreased with increasing serum cholesterol concentrations. Compared to the lowest quintile, the HRs (95%CI), for each higher quintile (in ascending order) are 0.83 (0.59-1.16); 0.86 (0.61-1.20); 0.84 (0.60-1.18); and 0.75 (0.52-1.09). The HR for one standard deviation (SD) increase = 0.90 [(0.80-1.01), p for trend = 0.09]. This trend was found in males (HR per SD = 0.88 [(0.77-1.00), p for trend = 0.05], but not in females [HR = 1.03 (0.81-1.32)].

CONCLUSIONS:
This secondary analysis of the DATATOP trial provides preliminary evidence that higher total serum cholesterol concentrations may be associated with a modest slower clinical progression of PD, and this preliminary finding needs confirmation from larger prospective studies.

PMID: 21853051 [PubMed - as supplied by publisher]
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#2 netgypsy

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Posted 20 August 2011 - 11:57 PM

When reading this a thought occurred to me that people with lower cholesterol may have dieted or simply don't pick up body fat. Many toxins are stored in body fat so quite possibly people with more body fat simply have stored the toxins rather than their being released into the system and damaging the nervous system. Another interesting study comes to mind and that is one in which PD rates are compared between a normal population that simply gains some weight as it ages and one in which at some point in their lives they have lost considerable weight and remained at that lower weight for extended periods of time. Every time we diet and lose fat we dump toxins into our systems so a weight control facility could also monitor toxin levels in their obese population as they lose weight. I wonder if thin people are more prone to PD because they don't have the fat and the ability to stores toxins. HMMMMM

Dear Forum Members,

This paper is a large subanalysis from the DATATOP paper (published in the early 90's). They looked at blood samples and found there may be a slighly slower progression in PD with moderately higher cholesterol. We do not recommend eating poorly to try to raise your cholesterol as this was a retrospective study and should not alter treatment. We do think this data may offer some clues about the pathogenesis and progression of PD. Here is the abstract published:

PLoS One. 2011;6(8):e22854. Epub 2011 Aug 11.
Serum Cholesterol and the Progression of Parkinson's Disease: Results from DATATOP.
Huang X, Auinger P, Eberly S, Oakes D, Schwarzschild M, Ascherio A, Mailman R, Chen H; for the Parkinson Study Group DATATOP Investigators.
Source
Departments of Neurology, Neurosurgery, Pharmacology, Radiology, and Kinesiology, Pennsylvania State University-Milton Hershey Medical Center, Hershey, Pennsylvania, United States of America.
Abstract
BACKGROUND:
Recent studies have suggested that higher serum cholesterol may be associated with lower occurrence of Parkinson's disease (PD). This study is to test the hypothesis that higher serum cholesterol correlates with slower PD progression.

METHODS:
Baseline non-fasting serum total cholesterol was measured in 774 of the 800 subjects with early PD enrolled between 1987 and 1988 in the Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP) trial. Participants were followed for up to two years, with clinical disability requiring levodopa therapy as the primary endpoint. Hazard ratios (HRs) and 95% confidence intervals (CI) were determined for increasing serum cholesterol concentration (in quintiles) for clinical disability requiring levodopa therapy, after adjusting for confounders. At baseline, only nine subjects reported use of cholesterol-lowering agents (two with statins).

RESULTS:
The overall mean cholesterol level was 216 mg/dL (range 100-355). The HR of progressing to the primary endpoint decreased with increasing serum cholesterol concentrations. Compared to the lowest quintile, the HRs (95%CI), for each higher quintile (in ascending order) are 0.83 (0.59-1.16); 0.86 (0.61-1.20); 0.84 (0.60-1.18); and 0.75 (0.52-1.09). The HR for one standard deviation (SD) increase = 0.90 [(0.80-1.01), p for trend = 0.09]. This trend was found in males (HR per SD = 0.88 [(0.77-1.00), p for trend = 0.05], but not in females [HR = 1.03 (0.81-1.32)].

CONCLUSIONS:
This secondary analysis of the DATATOP trial provides preliminary evidence that higher total serum cholesterol concentrations may be associated with a modest slower clinical progression of PD, and this preliminary finding needs confirmation from larger prospective studies.

PMID: 21853051 [PubMed - as supplied by publisher]



#3 Dr. Okun

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Posted 21 August 2011 - 08:31 AM

Thanks for the comment. These are big unknowns but very interesting.

I will also add that the natural tendency is to slowly but steadily lose weight with PD.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#4 vipowitz

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Posted 24 August 2011 - 07:10 PM

there has been commentary concerning long term statin drug use and parkinsonian symptoms. I myself have taken pravastatin (zocor) for 9 years, then developed PD. Has anyone had a similar experience?

#5 Dr. Okun

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Posted 25 August 2011 - 06:38 AM

Thanks for the post. I will weigh in with my opinion that the development of your PD was unlikely due to the statin.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips




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