Serum urate as a predictor of clinical and radiographic progression in Parkinson disease
Serum urate as a predictor of clinical and radiographic progression in Parkinson disease
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DOI：
10.1001/archneur.2008.65.6.nct70003
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发表时间：
2008-06-01
影响因子：
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通讯作者：
Ascherio, Alberto
中科院分区：
文献类型：
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作者：
Schwarzschild, Michael A.;Schwid, Steven R.;Ascherio, Alberto
目的：确定血清尿酸盐（一种嘌呤代谢物和有效抗氧化剂，与帕金森病 (PD) 风险降低有关）的浓度是否可以预测帕金森病 (PD) 的预后。设计：前瞻性研究。背景：CEP-1347 试验的帕金森研究检查 (PRECEPT) 研究于 2002 年 4 月至 2005 年 8 月期间进行，该研究调查了潜在的神经保护剂对帕金森病进展率的影响（平均随访时间 21.4 个月）。参与者：804 名患有早期 PD 的受试者参加了 PRECEPT 研究。主要结果指标：主要研究终点是进展到足以保证多巴胺能治疗的临床残疾。 Cox比例风险模型用于根据基线血清尿酸盐浓度的五分位数来估计达到终点的风险比（HR），并调整性别、年龄和其他潜在协变量。对 399 名受试者的子集进行线性回归评估纹状体对碘 I123 标记的 2-β-甲氧甲氧基-3-β-(4-碘苯基)托烷 ([I-123]β-CIT)（突触前多巴胺转运蛋白的标志物）摄取的变化。结果：随着尿酸盐基线浓度的增加，达到终点的调整 HR 下降；排名前五分位的受试者仅以排名后五分位受试者的一半比率达到终点（HR，0.51；95% 置信区间 [CI]，0.37-0.72；P 表示趋势
Objective: To determine whether concentration of serum urate, a purine metabolite and potent antioxidant that has been linked to a reduced risk of Parkinson disease (PD), predicts prognosis in PD.Design: Prospective study.Setting: The Parkinson Research Examination of CEP-1347 Trial (PRECEPT) study, which investigated the effects of a potential neuroprotectant on rates of PD progression, was conducted between April 2002 and August 2005 (average follow-up time 21.4 months).Participants: Eight hundred four subjects with early PD enrolled in the PRECEPT study.Main Outcome Measures: The primary study end point was progression to clinical disability sufficient to warrant dopaminergic therapy. Cox proportional hazards models were used to estimate the hazard ratio (HR) of reaching end point according to quintiles of baseline serum urate concentration, adjusting for sex, age, and other potential covariates. Change in striatal uptake of iodine I123-labeled 2-beta-carbomethoxy-3-beta-(4-iodophenyl) tropane ([I-123]beta-CIT), amarker for the presynaptic dopamine transporter, was assessed with linear regression for a subset of 399 subjects.Results: The adjusted HR of reaching end point declined with increasing baseline concentrations of urate; subjects in the top quintile reached the end point at only half the rate of subjects in the bottom quintile (HR, 0.51; 95% confidence interval [CI], 0.37-0.72; P for trend