Objective: To estimate the levels of serum uric acid in Idiopathic Parkinson’s disease (IPD) and various Parkinson plus syndromes (PPS). To correlate the uric acid levels with duration and severity of illness and evaluate the role of serum uric acid as the diagnostic and prognostic marker in PD

Background: Uric acid is the end product of purine metabolism and is major antioxidant. The amount of uric acid in blood depends on dietary intake of purines, biosynthesis of uric acid and excretion. As a major antioxidant and having metal complexing properties, it is postulated to play an important role in preventing neurodegeneration in PD. Recent studies have shown an inverse association between high serum uric acid and risk of developing PD. We evaluated the role of serum uric acid as the diagnostic and prognostic marker in PD.

Methods: Current study included 99 patients with Parkinsonism and 68 healthy volunteers. Patients were diagnosed with IPD, multisystem atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal ganglionic degeneration (CBGD) as per standard criteria. Written informed consent was obtained from all patients included in the study. All patients underwent UPDRS (Unified Parkinson Disease Rating Scale) and MRI brain. Serum Uric acid was estimated according to manufacturer’s instructions using Infinite Uric acid assay kit (Accurex Biomedical PVT.LTD., Mumbai, INDIA) on UV Spectrophotometer.

Results: Mean Serum Uric acid levels for total PD patients was 5.16 mg/dl and 7.45 mg/dl for controls. We found that there was a significant decrease of serum uric acid levels in cases compared to healthy controls (p<0.001). Our study also observed significant inverse correlation of serum Uric acid levels with age at onset (r = - 0.206, p= 0.04). However, our study did not find any correlation of serum Uric acid levels with disease severity as measured by UPDRS motor score III and H&Y staging. Besides this, no correlation of serum Uric acid levels with duration of illness was observed. There was no difference in serum uric acid levels between IPD and PPS (p=0.30).

Conclusions: Serum uric acid levels were significantly lower in PD as compared to controls. Uric acid levels showed inverse correlation with age at onset, but we could not find any significant difference in uric acid levels between PD and PPS groups, as well as the severity of disease.

References: 1. Cipriani S, Chen X, Schwarzschild MA. Urate: a novel biomarker of Parkinson’s disease risk, diagnosis and prognosis. Biomark Med. 2010; 4(5): 701–12. 2. Schwarzschild MA, Marek K, Eberly S, Oakes D, Shoulson I, Jennings D et al. Serum urate and probability of dopaminergic deficit in early Parkinson disease. Mov Disord 2011; 26(10): 1864–8. 3. Fahn S, Cohen G. The oxidant stress hypothesis in Parkinson’s disease: evidence supporting it. Ann. Neurol 1992;32(6): 804–12. 4. Kehrer JP. The Haber-Weiss reaction and mechanisms of toxicity. Toxicology 2000;149(1):43–50. 5. Brody DM, Litvan I, Warner S, Riley DE, Hall DA, Kluger BM, et al. Relationship between uric acid levels and progressive supranuclear palsy. Mov Disord. 2016; 31(5):663-7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/role-of-uric-acid-as-a-prognostic-biomarker-in-idiopathic-parkinsons-disease-and-parkinson-plus-syndrome/