Supplementary Material for: Associations of Body Mass Index-Metabolic Phenotypes with Cognitive Decline in Parkinson’s Disease

<b><i>Background:</i></b> Growing evidence suggests important effects of body mass index (BMI) and metabolic status on neurodegenerative diseases. However, the roles of BMI and metabolic status on cognitive outcomes in Parkinson’s disease (PD) may vary and are yet to be determined. <b><i>Methods:</i></b> In total, 139 PD patients from the whole PD cohort in Parkinson’s Progression Markers Initiative database underwent complete laboratory measurements, demographic and anthropometric parameters at baseline, and were enrolled in this study. Further, they were categorized into 4 different BMI-metabolic status phenotypes using Adult Treatment Panel-III criteria. Motor and cognition scales at baseline and longitudinal changes after a 48-month follow-up were compared among the 4 groups. Repeated-measure linear mixed models were performed to compare PD-related biomarkers among BMI-metabolic status phenotypes across time. <b><i>Results:</i></b> We found that PD patients in the metabolically unhealthy normal weight group showed more cognitive decline in global cognition and visuospatial perception after a 48-month follow-up than those in the other 3 groups (<i>p</i> &lt; 0.05). No difference was found in motor scales among different BMI-metabolic status phenotypes. Finally, compared to the metabolically healthy normal weight group, the metabolically healthy obesity group had lower CSF Aβ42 and serum neurofilament levels in repeated-measure linear mixed models adjusting for age, gender, APOE e4 carrier status, and years of education (<i>p</i> = 0.031 and 0.046, respectively). <b><i>Conclusion:</i></b> The MUNW phenotype was associated with a rapid cognitive decline in PD.