Study of Factors Associated With the Volumetric and Areal Bone Mineral Density and Bone Strength in Parkinson's Disease

Study Overview
=================
Brief Summary
-----------------
Studies show that patients with idiopathic Parkinson's disease (IPD) have an increased risk of fracture, particularly hip fracture whose complications and postoperative mortality appear to be higher than in the general population. This increased risk of fracture is due partly to an increased risk of falling, and secondly to an impairment of bone tissue with lower bone mineral density (BMD). A meta-analysis concluded that patients with IPD have lower BMD than healthy controls. Prospective studies also showed rapid bone loss in these patients compared with controls. The association between low BMD and IPD seems dependent on the severity and duration of the disease even if some data are contradictory. Various mechanisms may explain this bone loss including weight loss, malnutrition and a low level of physical activity. However, enrollments in these studies are often weak and it is difficult to conclude on the real impact of these factors on bone loss in the IPD. The main objective of our study is to assess and prioritize from these various bone loss mechanisms. Bone assessment by peripheral quantitative computed tomography (pQCT) will also assess the impact of various risk factors on bone strength parameters. The prevalence of vertebral compression fractures in the IPD, at this day unknown can be evaluated. This study will also estimate the prevalence of vertebral compression fractures in the IPD.

Detailed Description
-----------------
Studies show that patients with idiopathic Parkinson's disease (IPD) have an increased risk of fracture, particularly hip fracture whose complications and postoperative mortality appear to be higher than in the general population. This increased risk of fracture is due partly to an increased risk of falling, and secondly to an impairment of bone tissue with lower bone mineral density (BMD). A meta-analysis concluded that patients with IPD have lower BMD than healthy controls. Prospective studies also showed rapid bone loss in these patients compared with controls. The association between low BMD and IPD seems dependent on the severity and duration of the disease even if some data are contradictory. Various mechanisms may explain this bone loss including weight loss, malnutrition and a low level of physical activity. However, enrollments in these studies are often weak and it is difficult to conclude on the real impact of these factors on bone loss in the IPD. The main objective of our study is to assess and prioritize from these various bone loss mechanisms. Bone assessment by peripheral quantitative computed tomography (pQCT) will also assess the impact of various risk factors on bone strength parameters. The prevalence of vertebral compression fractures in the IPD, at this day unknown can be evaluated. This study will also estimate the prevalence of vertebral compression fractures in the IPD.

Official Title
-----------------
Study of Factors Associated With the Volumetric and Areal Bone Mineral Density and Bone Strength in Parkinson's Disease

Conditions
-----------------
Parkinson's Disease

Intervention / Treatment
-----------------
* Procedure: DXA scan
* Procedure: pQCT scan


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Idiopathic parkinson's disease (UKPDSBB criteria) Hoen and Yahr score < 4 (ON periods) Age between 35 and 70 years old Independent person at home Exclusion Criteria: Dementia patient and progressive mental illness Patient with severe tremor Incapacity to walk over ten minutes Treatment influencing bone metabolism Disease influencing phosphocalcic metabolism Severe comorbidities Pregnant woman

Ages Eligible for Study
-----------------
Minimum Age: 35 Years
Maximum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with idiopathic Parkinson's disease<br> | Procedure: DXA scan<br> <br> Procedure: pQCT scan<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total bone mineral density of the tibia and radius quantified by peripheral quantitative computed tomography (pQCT) |  | at day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trabecular and cortical bone mineral density of the tibia and the radius |  | at day 1 | 
| Architectural parameters and bone resistance of the tibia and radius measured by pQCT |  | at day 1 | 
| Axial muscular area of the tibia and radius measured by pQCT |  | at day 1 | 
| Bone mineral density of the lumbar spine and hip measured by DXA |  | at day 1 | 
| body composition by DXA |  | at day 1 | 
| Parkinson's disease score |  | at day 1 | 
| Bone turnovers markers (CTX), 25 OH vitamin D |  | at day 1 | 
| Vertebral fracture assessment (VFA) |  | at day 1 | 
| Trabecular bone score of the lumbar spine |  | at day 1 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Bone mineral density, Osteoporosis, Parkinson's disease, Bone turnover markers