ArticleFrontiers in nutrition2026
Association between the prognostic nutritional index and impulse control disorders in patients with early-stage Parkinson's disease.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Impulse control disorders (ICDs) are common non-motor symptoms in Parkinson's disease (PD) and associated with significant psychiatric morbidity and reduced quality of life. The prognostic nutritional index (PNI) reflects both nutritional and immune status. However, the relationship between PNI and ICDs in early-stage PD remains unknown. Methods: This cross-sectional study included 1,302 early-stage PD patients (Hoehn and Yahr stages 1-3) from the Parkinson's Progression Markers Initiative (PPMI) database. Logistic regression models were constructed with sequential adjustment for demographic, clinical, neuropsychiatric, metabolic, and laboratory covariates. Sensitivity analyses included complete-case analysis, exclusion of participants with abnormal liver or renal function, and propensity score-based methods (IPTW, SMRW, PA). Receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess incremental predictive value. Results: The overall prevalence of ICDs was 22.6% (294/1,302). In the fully adjusted model, each 1-unit increase in PNI was associated with 5% lower odds of ICDs (OR = 0.95, 95% CI: 0.92-0.98, Conclusions: Higher PNI is independently associated with lower odds of ICDs in early-stage PD patients. PNI, a simple and readily available composite marker of nutritional and immune status, may serve as a valuable adjunctive tool for discriminating PD patients with higher odds of prevalent ICDs. Prospective longitudinal studies are warranted to establish causality and explore potential nutritional or immunomodulatory interventions.
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