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Serum urate and probability of dopaminergic deficit in early “Parkinson's disease”
Author(s) -
Schwarzschild Michael A.,
Marek Kenneth,
Eberly Shirley,
Oakes David,
Shoulson Ira,
Jennings Danna,
Seibyl John,
Ascherio Alberto
Publication year - 2011
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.23741
Subject(s) - dopamine transporter , dopaminergic , putamen , odds ratio , medicine , parkinsonism , endocrinology , parkinson's disease , dopamine , gastroenterology , disease
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. © 2011 Movement Disorder Society