Objective: To investigate whether serum uric acid level is gender-specifically associated with the development of freezing of gait (FOG) in patients with de novo Parkinson’s disease (PD).

Background: Uric acid, a major antioxidant, is one of the candidates that can modulate the clinical progression of PD. However, its neuroprotective effect appears to differ according to gender.

Method: We reviewed medical records of 159 patients with de novo PD (85 males and 74 females; follow-up > 2 years). The patients were subdivided into the tertile groups by gender, based on the distribution of uric acid level: PD with the lowest uric acid level (PD-L-UA, n = 29; uric acid < 4.7 mg/dL), PD with an intermediate uric acid level (PD-I-UA, n = 28; 4.7 ≦ uric acid ≦ 5.9 mg/dL), and PD with the highest uric acid level (PD-H-UA, n = 28; uric acid > 5.9 mg/dL) in males; PD-L-UA (n = 24; uric acid < 3.8 mg/dL), PD-I-UA (n = 27; 3.8 ≦ uric acid ≦ 4.5 mg/dL), and PD-H-UA (n = 23; uric acid > 4.5 mg/dL) in females. Then, we performed comparative analyses of the risk for developing FOG between the PD tertile groups by gender, separately.

Results: There was no significant difference in age, disease duration, and parkinsonian motor severity between the PD groups according to the uric acid level. The risk of development of FOG was similar between the groups in male PD patients. In contrast, the risk of developing FOG was higher in the PD-H-UA group than the PD-L-UA group (PLog-rank = 0.010) in female patients. After adjusting for age, striatal dopamine transporter availability, white matter hyperintensities, and levodopa-equivalent dose, we obtained consistent results that female patients in the PD-H-UA group had a higher risk of developing FOG than those in the PD-L-UA group (hazard ratio, 4.132; 95% confidence interval, 1.070-15.960; p = 0.040).

Conclusion: Our findings suggest that serum uric acid level might be gender-specifically associated with the development of FOG in patients with PD. Low uric acid levels were associated with a low risk for FOG in female patients, and further verification studies are needed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-specific-effects-of-uric-acid-on-the-development-of-freezing-of-gait-in-parkinsons-disease/