Serum urate and probability of dopaminergic deficit in early "Parkinson's disease".

Abstract

The objective of this study was to investigate whether higher levels of urate, an antioxidant linked to a lower likelihood of developing Parkinson's disease, is also a predictor of having a dopamine transporter brain scan without evidence of dopaminergic deficit. In a cross-sectional study of 797 mildly affected, untreated parkinsonian subjects diagnosed with early Parkinson's disease in the Parkinson Research Examination of CEP-1347 Trial, we investigated the relationship at baseline between serum urate and striatal dopamine transporter density, determined by single-photon emission computed tomography of iodine-123-labeled 2-β-carboxymethoxy-3-β-(4-iodophenyl)tropane uptake. A scan without evidence of dopaminergic deficit was defined as lowest putamen iodine-123-labeled 2-β-carboxymethoxy-3-β-(4-iodophenyl)tropane > 80% age-expected putamen dopamine transporter density. The odds of having a scan without evidence of dopaminergic deficit rose across increasing quintiles of urate level, with an age- and sex-adjusted odds ratio of 3.2 comparing the highest to the lowest urate quintile (95% confidence interval, 1.5-7.2; P for trend = .0003), and remained significant after adjusting for potential confounding factors. The association was significant in men but not women, regardless of whether common or sex-specific quintiles of urate were used. Higher levels of urate were associated with a greater likelihood of a scan without evidence of dopaminergic deficit among subjects with early untreated parkinsonism in the Parkinson Research Examination of CEP-1347 Trial. The findings support the diagnostic utility of urate in combination with other determinants.

• Authors: Michael A Schwarzschild, Kenneth Marek, Shirley Eberly, David Oakes, Ira Shoulson, Danna Jennings, John Seibyl, Alberto Ascherio, Parkinson Study Group PRECEPT Investigators
• Journal: Movement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 26 Issue 10 Pg. 1864-8 (Aug 15 2011) ISSN: 1531-8257 [Electronic] United States
• PMID: 21538532 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2011 Movement Disorder Society.

Chemical References

• Dopamine Plasma Membrane Transport Proteins
• Tropanes
• 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
• Uric Acid
• Dopamine

Topics

• Adult
• Aged
• Dopamine (metabolism)
• Dopamine Plasma Membrane Transport Proteins (deficiency)
• Female
• Humans
• Male
• Middle Aged
• Odds Ratio
• Parkinson Disease (blood, diagnostic imaging, metabolism)
• Probability
• Retrospective Studies
• Sex Factors
• Tomography, Emission-Computed, Single-Photon
• Tropanes
• Uric Acid (blood)