J Clin Neurol.  2015 Oct;11(4):376-382. 10.3988/jcn.2015.11.4.376.

Prognostic Role of Serum Levels of Uric Acid in Amyotrophic Lateral Sclerosis

Affiliations
  • 1Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 2Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea. kimsh1@hanyang.ac.kr
  • 3Department of Neurology, College of Medicine, Yanbian University Hospital, Yanji, China.

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 beneficial in the prevention or treatment of this disease. The 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 defined by the ALS Functional Rating Scale-Revised (ALSFRS-R).
RESULTS
The study included 136 ALS patients and 136 matched controls. The 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.

Keyword

amyotrophic lateral sclerosis; uric acid; survival; oxidative stress; prognosis

MeSH Terms

Amyotrophic Lateral Sclerosis*
Antioxidants
Body Mass Index
Disease Progression
Hematologic Tests
Humans
Kaplan-Meier Estimate
Oxidative Stress
Prognosis
Prospective Studies
Survival Rate
Uric Acid*
Antioxidants
Uric Acid

Figure

  • Fig. 1 Correlation between serum uric acid (UA) level and disease progression rate (ΔFS). Slower progression of amyotrophic lateral sclerosis was correlated with a higher level of serum UA.

  • Fig. 2 Kaplan-Meier survival curves using stratified serum UA levels. The tertile ranges of serum UA levels differed with sex. The tertile ranges were classified as <4.7, 4.7-5.4, and >5.4 mg/dL in male subjects, and as <3.7, 3.7-4.4, and >4.4 mg/dL in female subjects. The survival curves demonstrate a relationship between the serum UA level and survival rate in the total population. UA: uric acid.


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