Prognostic Role of Serum Levels of Uric Acid in Amyotrophic Lateral Sclerosis
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Background and Purpose It has been suggested that oxidative stress is one of the pathomechanisms underlying amyotrophic lateral sclerosis (ALS), and thus antioxidants such as uric acid (UA) that could reduce oxidative stress might be benefcial in the prevention or treatment of this disease. Te objective of this study was to prospectively investigate serum UA levels in Korean ALS patients and to relate them to disease progression. Methods ALS patients and healthy controls who were individually well-matched for sex, age, and body mass index (BMI) underwent blood testing for serum UA levels, and analyzed whether UA levels were correlated with the disease status of the patients, as defned by the ALS Functional Rating Scale-Revised (ALSFRS-R). Results Te study included 136 ALS patients and 136 matched controls. Te UA level was lower in the ALS patients (4.50±1.17 mg/dL, mean±SD) than in the controls (5.51±1.22 mg/ dL; p<0.001). Among the ALS patients, the level of UA acid was inversely correlated with the rate of disease progression (decrease in ALSFRS-R score). Kaplan-Meier analysis revealed that a better survival rate was more strongly correlated with top-tertile levels of serum UA than with bottom-tertile levels (log-rank test: p=0.035). Conclusions ALS patients had lower serum UA levels than did healthy individuals. UA levels in ALS were negatively correlated with the rate of disease progression and positively associated with survival, suggesting that UA levels contribute to the progression of ALS. UA levels could be considered a biomarker of disease progression in the early phase in ALS patients.
Abstract
Background and Purpose It has been suggested that oxidative stress is one of the pathomechanisms underlying amyotrophic lateral sclerosis (ALS), and thus antioxidants such as uric acid (UA) that could reduce oxidative stress might be benefcial in the prevention or treatment of this disease. Te objective of this study was to prospectively investigate serum UA levels in Korean ALS patients and to relate them to disease progression. Methods ALS patients and healthy controls who were individually well-matched for sex, age, and body mass index (BMI) underwent blood testing for serum UA levels, and analyzed whether UA levels were correlated with the disease status of the patients, as defned by the ALS Functional Rating Scale-Revised (ALSFRS-R). Results Te study included 136 ALS patients and 136 matched controls. Te UA level was lower in the ALS patients (4.50±1.17 mg/dL, mean±SD) than in the controls (5.51±1.22 mg/ dL; p<0.001). Among the ALS patients, the level of UA acid was inversely correlated with the rate of disease progression (decrease in ALSFRS-R score). Kaplan-Meier analysis revealed that a better survival rate was more strongly correlated with top-tertile levels of serum UA than with bottom-tertile levels (log-rank test: p=0.035). Conclusions ALS patients had lower serum UA levels than did healthy individuals. UA levels in ALS were negatively correlated with the rate of disease progression and positively associated with survival, suggesting that UA levels contribute to the progression of ALS. UA levels could be considered a biomarker of disease progression in the early phase in ALS patients.
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