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Contra-Directional Expression of Serum Homocysteine and Uric Acid as Important Biomarkers of Multiple System Atrophy Severity: A Cross-Sectional Study.

Chen D, Wei X, Zou J, Wang R, Liu X, Xu X, Lu J, Wang Z, Tang B, Wang B, Jin K, Wang Q - Front Cell Neurosci (2015)

Bottom Line: Serum Hcy was higher in MSA patients when compared to healthy subjects, particularly in male patients.Serum UA was lower in MSA patients when compared healthy subjects, particularly in male patients.Serum Hcy levels were significantly positively correlated with the severity of MSA.The ROC curve for the combination of Hcy and UA showed potential diagnostic value in discriminating MSA from healthy subjects.Compared with healthy subjects, we found that serum Hcy was higher, UA was lower, and CRP levels were unchanged in MSA patients.Interestingly, there was a significant correlation between Hcy levels and MSA severity such as movement dysfunction, declined cognition, and cardiovascular symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.

ABSTRACT

Highlights: Serum Hcy was higher in MSA patients when compared to healthy subjects, particularly in male patients.Serum UA was lower in MSA patients when compared healthy subjects, particularly in male patients.Serum Hcy levels were significantly positively correlated with the severity of MSA.The ROC curve for the combination of Hcy and UA showed potential diagnostic value in discriminating MSA from healthy subjects.

Aim: There is evidence suggesting that inflammatory responses play a critical role in the pathogenesis of multiple system atrophy (MSA). Whether inflammatory mediators can be used as reliable biomarkers to detect the severity and progression of MSA remains largely unknown.

Methods: We performed a cross-sectional study that included 47 patients with MSA and 50 healthy age-matched controls. Serum levels of homocysteine (Hcy), uric acid (UA), and C-reactive protein (CRP) were measured. These levels positively correlated with the severity of MSA, based on both motor and non-motor symptoms. Several scales were used to rate the severity of MSA, including the Unified multiple system atrophy rating scale, Parkinson's disease sleep scale, Non-motor Symptoms Scale, the Schwab & England activities of daily living scale, Webster Scale, modified Hoehn and Yahr staging scale, and the Mini-Mental State Examination. Receiver operating characteristic (ROC) curves was applied to map the diagnostic accuracy of MSA against healthy subjects.

Results: Compared with healthy subjects, we found that serum Hcy was higher, UA was lower, and CRP levels were unchanged in MSA patients. These findings were especially prominent in male patients. No significant differences of serum Hcy and UA were observed between patients of MSA and PD. Interestingly, there was a significant correlation between Hcy levels and MSA severity such as movement dysfunction, declined cognition, and cardiovascular symptoms. Additionally, the ROC curve for the combination of Hcy and UA (AUC 0.736) showed potential diagnostic value in discriminating MSA from healthy subjects.

Conclusion: Our findings suggest that the inflammatory mediators Hcy and UA may play important roles in the pathogenesis of MSA. The measurement of serum Hcy and UA levels could then be a useful tool to accurately distinguish MSA from healthy subjects.

No MeSH data available.


Related in: MedlinePlus

Comparison of CRP, Hcy, and UA levels between MSA and control patients, according to gender. (A) Comparison of CRP between control and MSA groups. No significant differences of CRP levels were found between MSA vs. control, MSA (male)vs. control (male), MSA (female)vs. control (female) and MSA (male) vs. MSA (female). (B) Comparison of Hcy between control and MSA groups. ***MSA (male) vs. control (male), p < 0.001; ♢MSA (male) vs. MSA (female), p = 0.023; ##MSA vs. control, p  = 0.002. (C) Comparison of UA between control and MSA groups. **MSA (male) vs. control (male), p = 0.007; ♢MSA (male) vs. MSA (female), p = 0.009; ##MSA vs. control, p  = 0.011.
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Figure 2: Comparison of CRP, Hcy, and UA levels between MSA and control patients, according to gender. (A) Comparison of CRP between control and MSA groups. No significant differences of CRP levels were found between MSA vs. control, MSA (male)vs. control (male), MSA (female)vs. control (female) and MSA (male) vs. MSA (female). (B) Comparison of Hcy between control and MSA groups. ***MSA (male) vs. control (male), p < 0.001; ♢MSA (male) vs. MSA (female), p = 0.023; ##MSA vs. control, p  = 0.002. (C) Comparison of UA between control and MSA groups. **MSA (male) vs. control (male), p = 0.007; ♢MSA (male) vs. MSA (female), p = 0.009; ##MSA vs. control, p  = 0.011.

Mentions: When MSA patients and healthy subjects were divided into specific gender groups, the serum levels of Hcy in the male patients with MSA were higher than that of the normal male subjects (14.26 ± 3.67 vs. 10.77 ± 2.94, ***p  = 0.000, Student’s t-test, Table 4). Similarly, a significant difference was observed in plasma UA levels of MSA male patients and normal male subjects (337.45 ± 80.86 vs. 397.74 ± 84.49, **p = 0.007, Mann–Whitney U-test, Table 4). Interestingly, there was no significant difference between both Hcy and UA levels in female MSA patients and healthy female subjects. Additionally, the level of Hcy in male MSA patients was higher than that in the female patients (14.26 ± 3.67 vs. 11.40 ± 4.44, *p  = 0.023, Student’s t-test, Table 4); the serum UA levels in male patients were higher than those in female patients with MSA (337.45 ± 80.86 vs. 272.32 ± 71.67, **p = 0.009, Student’s t-test, Table 4). On the contrary, no significant differences in serum CRP levels were observed between the MSA patients and healthy subjects; there were also no significant differences in the serum CRP levels between male MSA patients and female MSA patients (Table 4; Figure 2).


Contra-Directional Expression of Serum Homocysteine and Uric Acid as Important Biomarkers of Multiple System Atrophy Severity: A Cross-Sectional Study.

Chen D, Wei X, Zou J, Wang R, Liu X, Xu X, Lu J, Wang Z, Tang B, Wang B, Jin K, Wang Q - Front Cell Neurosci (2015)

Comparison of CRP, Hcy, and UA levels between MSA and control patients, according to gender. (A) Comparison of CRP between control and MSA groups. No significant differences of CRP levels were found between MSA vs. control, MSA (male)vs. control (male), MSA (female)vs. control (female) and MSA (male) vs. MSA (female). (B) Comparison of Hcy between control and MSA groups. ***MSA (male) vs. control (male), p < 0.001; ♢MSA (male) vs. MSA (female), p = 0.023; ##MSA vs. control, p  = 0.002. (C) Comparison of UA between control and MSA groups. **MSA (male) vs. control (male), p = 0.007; ♢MSA (male) vs. MSA (female), p = 0.009; ##MSA vs. control, p  = 0.011.
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Figure 2: Comparison of CRP, Hcy, and UA levels between MSA and control patients, according to gender. (A) Comparison of CRP between control and MSA groups. No significant differences of CRP levels were found between MSA vs. control, MSA (male)vs. control (male), MSA (female)vs. control (female) and MSA (male) vs. MSA (female). (B) Comparison of Hcy between control and MSA groups. ***MSA (male) vs. control (male), p < 0.001; ♢MSA (male) vs. MSA (female), p = 0.023; ##MSA vs. control, p  = 0.002. (C) Comparison of UA between control and MSA groups. **MSA (male) vs. control (male), p = 0.007; ♢MSA (male) vs. MSA (female), p = 0.009; ##MSA vs. control, p  = 0.011.
Mentions: When MSA patients and healthy subjects were divided into specific gender groups, the serum levels of Hcy in the male patients with MSA were higher than that of the normal male subjects (14.26 ± 3.67 vs. 10.77 ± 2.94, ***p  = 0.000, Student’s t-test, Table 4). Similarly, a significant difference was observed in plasma UA levels of MSA male patients and normal male subjects (337.45 ± 80.86 vs. 397.74 ± 84.49, **p = 0.007, Mann–Whitney U-test, Table 4). Interestingly, there was no significant difference between both Hcy and UA levels in female MSA patients and healthy female subjects. Additionally, the level of Hcy in male MSA patients was higher than that in the female patients (14.26 ± 3.67 vs. 11.40 ± 4.44, *p  = 0.023, Student’s t-test, Table 4); the serum UA levels in male patients were higher than those in female patients with MSA (337.45 ± 80.86 vs. 272.32 ± 71.67, **p = 0.009, Student’s t-test, Table 4). On the contrary, no significant differences in serum CRP levels were observed between the MSA patients and healthy subjects; there were also no significant differences in the serum CRP levels between male MSA patients and female MSA patients (Table 4; Figure 2).

Bottom Line: Serum Hcy was higher in MSA patients when compared to healthy subjects, particularly in male patients.Serum UA was lower in MSA patients when compared healthy subjects, particularly in male patients.Serum Hcy levels were significantly positively correlated with the severity of MSA.The ROC curve for the combination of Hcy and UA showed potential diagnostic value in discriminating MSA from healthy subjects.Compared with healthy subjects, we found that serum Hcy was higher, UA was lower, and CRP levels were unchanged in MSA patients.Interestingly, there was a significant correlation between Hcy levels and MSA severity such as movement dysfunction, declined cognition, and cardiovascular symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.

ABSTRACT

Highlights: Serum Hcy was higher in MSA patients when compared to healthy subjects, particularly in male patients.Serum UA was lower in MSA patients when compared healthy subjects, particularly in male patients.Serum Hcy levels were significantly positively correlated with the severity of MSA.The ROC curve for the combination of Hcy and UA showed potential diagnostic value in discriminating MSA from healthy subjects.

Aim: There is evidence suggesting that inflammatory responses play a critical role in the pathogenesis of multiple system atrophy (MSA). Whether inflammatory mediators can be used as reliable biomarkers to detect the severity and progression of MSA remains largely unknown.

Methods: We performed a cross-sectional study that included 47 patients with MSA and 50 healthy age-matched controls. Serum levels of homocysteine (Hcy), uric acid (UA), and C-reactive protein (CRP) were measured. These levels positively correlated with the severity of MSA, based on both motor and non-motor symptoms. Several scales were used to rate the severity of MSA, including the Unified multiple system atrophy rating scale, Parkinson's disease sleep scale, Non-motor Symptoms Scale, the Schwab & England activities of daily living scale, Webster Scale, modified Hoehn and Yahr staging scale, and the Mini-Mental State Examination. Receiver operating characteristic (ROC) curves was applied to map the diagnostic accuracy of MSA against healthy subjects.

Results: Compared with healthy subjects, we found that serum Hcy was higher, UA was lower, and CRP levels were unchanged in MSA patients. These findings were especially prominent in male patients. No significant differences of serum Hcy and UA were observed between patients of MSA and PD. Interestingly, there was a significant correlation between Hcy levels and MSA severity such as movement dysfunction, declined cognition, and cardiovascular symptoms. Additionally, the ROC curve for the combination of Hcy and UA (AUC 0.736) showed potential diagnostic value in discriminating MSA from healthy subjects.

Conclusion: Our findings suggest that the inflammatory mediators Hcy and UA may play important roles in the pathogenesis of MSA. The measurement of serum Hcy and UA levels could then be a useful tool to accurately distinguish MSA from healthy subjects.

No MeSH data available.


Related in: MedlinePlus