Limits...
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

ROC curves to evaluate the utility of serum levels of CRP, UA, and Hcy for the discrimination of MSA patients from healthy controls. The AUC of ROC curves for (A) CRP, (B) Hcy, and (C) UA were 0.550 (95% CI: 0.434–0.666, p  = 0.396), 0.709 (95% CI: 0.604–0.813, ***p  < 0.001), and 0.638 (95% CI: 0.527–0.749, *p  = 0.019), respectively. The AUC of (D) Hcy + UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4492156&req=5

Figure 3: ROC curves to evaluate the utility of serum levels of CRP, UA, and Hcy for the discrimination of MSA patients from healthy controls. The AUC of ROC curves for (A) CRP, (B) Hcy, and (C) UA were 0.550 (95% CI: 0.434–0.666, p  = 0.396), 0.709 (95% CI: 0.604–0.813, ***p  < 0.001), and 0.638 (95% CI: 0.527–0.749, *p  = 0.019), respectively. The AUC of (D) Hcy + UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001).

Mentions: A ROC curve was conducted to explore whether CRP, Hcy, and UA could provide credible discrimination between MSA patients and normal subjects. The ROC of Hcy analysis revealed that an area under the curve (AUC) value of 0.709 (95% CI: 0.604–0.813, ***p  < 0.001, Figure 3B) was observed; the cutoff was at 13.68 μmol/L, with a sensitivity of 53% and specificity of 90%. The AUC of UA was 0.638 (95% CI: 0.527–0.749, *p  = 0.019, Figure 3C); the cutoff was at 318.65 μmol/L, with a sensitivity of 64% and specificity of 66%. However, the AUC of CRP was 0.550 (95% CI: 0.434–0.666, p  = 0.396, Figure 3A), indicating a non-significant difference. Furthermore, the AUC of the combination of Hcy and UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001, Figure 3D), with a sensitivity of 74% and a specificity of 60% at the cutoff of 0.43 on the predicted risk algorithm, indicating that this combination variable was more robust than Hcy or UA alone in distinguishing MSA patients from healthy controls.


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)

ROC curves to evaluate the utility of serum levels of CRP, UA, and Hcy for the discrimination of MSA patients from healthy controls. The AUC of ROC curves for (A) CRP, (B) Hcy, and (C) UA were 0.550 (95% CI: 0.434–0.666, p  = 0.396), 0.709 (95% CI: 0.604–0.813, ***p  < 0.001), and 0.638 (95% CI: 0.527–0.749, *p  = 0.019), respectively. The AUC of (D) Hcy + UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492156&req=5

Figure 3: ROC curves to evaluate the utility of serum levels of CRP, UA, and Hcy for the discrimination of MSA patients from healthy controls. The AUC of ROC curves for (A) CRP, (B) Hcy, and (C) UA were 0.550 (95% CI: 0.434–0.666, p  = 0.396), 0.709 (95% CI: 0.604–0.813, ***p  < 0.001), and 0.638 (95% CI: 0.527–0.749, *p  = 0.019), respectively. The AUC of (D) Hcy + UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001).
Mentions: A ROC curve was conducted to explore whether CRP, Hcy, and UA could provide credible discrimination between MSA patients and normal subjects. The ROC of Hcy analysis revealed that an area under the curve (AUC) value of 0.709 (95% CI: 0.604–0.813, ***p  < 0.001, Figure 3B) was observed; the cutoff was at 13.68 μmol/L, with a sensitivity of 53% and specificity of 90%. The AUC of UA was 0.638 (95% CI: 0.527–0.749, *p  = 0.019, Figure 3C); the cutoff was at 318.65 μmol/L, with a sensitivity of 64% and specificity of 66%. However, the AUC of CRP was 0.550 (95% CI: 0.434–0.666, p  = 0.396, Figure 3A), indicating a non-significant difference. Furthermore, the AUC of the combination of Hcy and UA was 0.736 (95% CI: 0.638–0.834, ***p  < 0.001, Figure 3D), with a sensitivity of 74% and a specificity of 60% at the cutoff of 0.43 on the predicted risk algorithm, indicating that this combination variable was more robust than Hcy or UA alone in distinguishing MSA patients from healthy controls.

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