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帕金森病患者血清尿酸水平降低与左旋多巴诱导的运动障碍。

Low serum uric acid levels and levodopa-induced dyskinesia in Parkinson's disease.

机构信息

Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre RS, Brazil.

Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil.

出版信息

Arq Neuropsiquiatr. 2023 Jan;81(1):40-46. doi: 10.1055/s-0043-1761294. Epub 2023 Mar 14.

Abstract

BACKGROUND

Levodopa is the most used and effective medication for motor symptoms of Parkinson disease (PD), its long-term use is associated with the appearance of levodopa-induced dyskinesia (LID). Uric acid (UA) is believed to play an important neuroprotective role in PD.

OBJECTIVE

To investigate if serum UA levels are related with the presence of LIDs in PD patients. Also, we investigated the associations among UA levels and clinical features of PD.

METHODS

We enrolled 81 PD patients (dyskinesia = 48; no dyskinesia = 33) in the present study. A blood sample was collected to evaluate serum UA levels, clinical evaluation included the following instruments: Montreal Cognitive Assessment (MoCA), Beck Depression Inventory II (BDI-II), MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Hoehn and Yahr (HY), and the sub-item 4.1 of MDS-UPDRS IV (score ≥ 1). Additional relevant clinical information was obtained by a clinical questionnaire.

RESULTS

Serum UA levels were lower in the dyskinesia group when compared with the no dyskinesia group. The same result was found in the UA levels of both men and women. The multivariate analysis showed lower uric acid levels were significantly associated with having dyskinesia (odds ratio [OR] = 0.424; 95% confidence interval [CI]: 0.221-0.746;  = 0.005). Additional analysis verified that serum UA levels are inversely correlated with depressive symptoms, disease duration, MDS-UPDRS IV and time spent with dyskinesia. A positive correlation was found with age at onset of PD symptoms.

CONCLUSIONS

The present study provides a possible role of serum UA levels in LID present in PD patients.

摘要

背景

左旋多巴是治疗帕金森病(PD)运动症状最常用且最有效的药物,其长期使用与左旋多巴诱导的运动障碍(LID)的出现有关。尿酸(UA)被认为在 PD 中发挥重要的神经保护作用。

目的

探讨 PD 患者血清 UA 水平与 LID 之间的关系。此外,还研究了 UA 水平与 PD 临床特征之间的关系。

方法

本研究纳入 81 例 PD 患者(有运动障碍组=48 例;无运动障碍组=33 例)。采集血样以评估血清 UA 水平,临床评估包括以下工具:蒙特利尔认知评估量表(MoCA)、贝克抑郁量表 II (BDI-II)、运动障碍学会统一帕金森病评定量表(MDS-UPDRS)、Hoehn 和 Yahr 量表(HY)以及 MDS-UPDRS IV 第四项的子项(评分≥1)。通过临床问卷获得其他相关临床信息。

结果

与无运动障碍组相比,有运动障碍组的血清 UA 水平较低。在男性和女性的 UA 水平中也发现了同样的结果。多变量分析显示,较低的尿酸水平与运动障碍显著相关(比值比 [OR] = 0.424;95%置信区间 [CI]:0.221-0.746; = 0.005)。进一步的分析证实,血清 UA 水平与抑郁症状、疾病持续时间、MDS-UPDRS IV 和运动障碍持续时间呈负相关,与 PD 症状发病年龄呈正相关。

结论

本研究为 PD 患者中血清 UA 水平与 LID 之间的关系提供了可能的作用机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c62c/10014208/cf6022a5e5cd/10-1055-s-0043-1761294-i220061-1.jpg

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