AUTHOR=Li Siying , Zhang Qingxi , Gao Yuyuan , Nie Kun , Liang Yanling , Zhang Yuhu , Wang Lijuan 

TITLE=Serum Folate, Vitamin B12 Levels, and Systemic Immune-Inflammation Index Correlate With Motor Performance in Parkinson's Disease: A Cross-Sectional Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.665075

DOI=10.3389/fneur.2021.665075

ISSN=1664-2295

ABSTRACT=The aim of this study was to investigate the influence of serum folate, vitamin B12 (VitB12) levels and inflammation-based scores on the motor performance status in Parkinson’s disease (PD). 
We retrospectively collected data from 148 consecutive idiopathic PD patients first admitted to our hospital. We measured whole blood count, albumin, lactate dehydrogenase, C-reactive protein, folate, VitB12 levels and calculated the inflammation-based scores. The following scales were applied to assess the motor performance status: activity of daily living scale (ADL, the Barthel Index), the Unified Parkinson’s Disease Rating Scale Part III (UPDRS-III) and Hoehn–Yahr (H-Y) classification.
The geometric mean of folate and VitB12 levels were 11.87 (ng/ml) and 330.52 (pmol/L), respectively. Folate deficiency (serum level <4.0 ng/mL) and VitB12 deficiency (serum level <133 pg/mL) were present in 0.7% and 5.4% of the patients. The mean prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) were 47.78±4.42 and 470.81±254.05. The multivariate analyses showed that serum VitB12 level (P = 0.002) and SII (P = 0.005) were significant factors for ADL score, serum folate (P = 0.027) and VitB12 (P = 0.037) levels for UPDRS-III score, serum folate (P = 0.066) and VitB12 (P = 0.017) levels for Hoehn–Yahr (H-Y) classification. The elevated folate level did correlate with greater decline in UPDRS-III score (P = 0.023) and H-Y classification (P = 0.003) and an obvious increase in ADL score (P = 0.048). SII was negatively associated (P < 0.001) with ADL score. The three-dimensional drawing, combined the effect of folate and VitB12 levels, showed that the lowest level of folate was associated with the lowest ADL score and the highest UPDRS-III score and H-Y classification.
This study indicates that serum folate, VitB12 levels and SII are significant factors on the motor performance status in PD. SII is negatively associated with the ADL. Elevated serum folate level correlates with mild motor impairment in PD.