Association of serum uric acid, homocystine and ferritin among amyotrophic lateral sclerosis patients
DOI:
https://doi.org/10.18203/2349-3933.ijam20210261Keywords:
Amyotrophic lateral sclerosis (ALS), Ferritin, Homocystine, Serum uric acidAbstract
Background: Amyotrophic lateral sclerosis (ALS) disease which is also known as motor neuron disease (MND) or Lou Gehrig's disease, is causes the death of neurons controlling voluntary muscles. There may have association of serum uric acid, homocystine and ferritin with amyotrophic lateral sclerosis. But we have not enough data regarding these issues. The aim of this study was to evaluate the association of serum uric acid, homocystine and ferritin with amyotrophic lateral sclerosis.
Methods: It was a case-control study conducted in the department of neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to December 2011. Finalized 76 study people were divided into two equal groups containing 38 participants in each. In group I (case group) there were 38 patients with ALS and in group II (control group) there were 38 healthy people. The correlation of annual decline of ALS Functional Rating Scale-Revised (ALS-FRS) and forced vital capacity (FVC) were analyzed. Data were collected through pre-designed questioners and processed and analyzed by using SPSS version 11.5.
Results: In this study the inverse correlation between serum uric acid and the annual decline of ALS-FRS in male, spearman rho correlation was -0.37 (p<0.01) and in female it was -0.78 (p<0.001). The inverse correlation between serum uric acid and the annual decline of FVC were in male, spearman rho correlation was -0.33 (p<0.05) and in female it was -0.39 (p<0.05). Inverse correlation between homocystine and the annual decline of ALS-FRS in male, spearman rho correlation was -0.42 (p<0.02) and in female, it was -0.64 (p<0.001). The inverse correlation between homocystine and the annual decline of FVC in male, spearman rho correlation was -0.41 (p<0.04) and in female, spearman rho correlation was -0.37 (p<0.05). The inverse correlation between serum ferritin and the annual decline of ALS-FRS in male, spearman rho correlation was 0.47 (p<0.01) and in female, spearman rho correlation was 0.76 (p<0.001). The inverse correlation between serum ferritin and the annual decline of FVC in male, spearman rho correlation was 0.49 (p<0.001) and in female, it was 0.71 (p<0.001).
Conclusions: In most of the cases we found significant correlation of serum uric acid, serum homocystine and serum ferritin with amyotrophic lateral sclerosis (ALS). So all these components would be considered as some potential indicators or bio-markers of amyotrophic lateral sclerosis (ALS).
References
Wijesekera LC, Leigh PN. Amyotrophic lateral sclerosis. Orphanet J Rare Dis. 2009;4(1):3.
Imam I, Ball S, Wright D, Hanemann CO, Zajicek JJJon. The epidemiology of motor neurone disease in two counties in the southwest of England. J Neurol. 2010;257(6):977-81.
Leigh P, Whitwell H, Garofalo O, Buller J, Swash M, Martin J, et al. Ubiquitin-immunoreactive intraneuronal inclusions in amyotrophic lateral sclerosis: morphology, distribution, and specificity. Brain. 1991;114(2):775-88.
Bracco L, Antuono P, Amaducci LJANS. Study of epidemiological and etiological factors of amyotrophic lateral sclerosis in the province of Florence, Italy. Acta Neurol Scand. 1979;60(2):112-24.
Talbot K. Motor neurone disease. Postgrad Med J. 2002;78:513-9.
Ringel S, Murphy J, Alderson M, Bryan W, England J, Miller R, et al. The natural history of amyotrophic lateral sclerosis. Neurol. 1993;43(7):1316.
Worms PMJJ. The epidemiology of motor neuron diseases: a review of recent studies. J Neurol Sci. 2001;191(1-2):3-9.
Al-Chalabi A, Hardiman O, Kiernan MC, Chiò A, Brooks B, Berg LHJTLN. Amyotrophic lateral sclerosis: moving towards a new classification system. Lancet Neurol. 2016;15 (11):1182-94.
Turner MR, Kiernan MC, Leigh PN, Talbot KJTLN. Biomarkers in amyotrophic lateral sclerosis. 2009;8(1):94-109.
Armon CJJ. Sports and trauma in amyotrophic lateral sclerosis revisited. J Neurol Sci. 2007;262(1-2):45-53.
Goodall EF, Morrison KE. Amyotrophic lateral sclerosis (motor neuron disease): proposed mechanisms and pathways to treatment. Expert Rev Mol Med. 2006;8 (11):1-22.
Kushiyama A, Nakatsu Y, Matsunaga Y, Yamamotoya T, Mori K, Ueda K, et al. Role of uric acid metabolism-related inflammation in the pathogenesis of metabolic syndrome components such as atherosclerosis and non-alcoholic steatohepatitis. Mediators Inflamm. 2016;2016:8603164.
Ames BN, Cathcart R, Schwiers E, Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant-and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci U S A. 1981;78 (11):6858-62.
Veen RC, Hinton DR, Incardonna F, Hofman FM. Extensive peroxynitrite activity during pro-gressive stages of central nervous system inflammation. J Neuroimmunol. 1997;77(1):1-7.
Pacher P, Beckman JS, Liaudet LJP. Nitric oxide and peroxynitrite in health and disease. Physiol Rev. 2007;87(1):315-424.
Davis J, Grandinetti A, Waslien C, Ross G, White L, Morens DJ. Observations on serum uric acid levels and the risk of idiopathic Parkinson's disease. Am J Epidemiol. 1996;144 (5):480-4.
Zoccolella S, Bendotti C, Beghi E, Logroscino G. Homocysteine levels and amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2010;11(1-2):140-7.
Elevated serum ferritin level as a predictor of reduced survival in patients with sporadic amyo-trophic lateral sclerosis in China: a retrospective study Available at https:// doi. org/ 10.1080/ 21678421. 2018.1555599. Accessed on 12 September 2020.
Qureshi M, Rogers JT, Cudkowicz ME. Serum ferritin and metal levels as risk factors for amyotrophic lateral sclerosis. Open Neurol J. 2008;2:51-4.
Logroscino G, Traynor BJ, Hardiman O, Chiò A, Mitchell D, Swingler RJ, et al. Incidence of amyotrophic lateral sclerosis in Europe. J Neurol Neurosurg Psych. 2010;81(4):385-90.
Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL. Bradley's neurology in clinical practice, 7th edition, Elsevier Health Sciences. 2015:1508.
Paganoni S, Zhang M, Zárate AQ, Jaffa M, Yu H, Cudkowicz ME, et al. Uric acid levels predict survival in men with amyotrophic lateral sclerosis. J Neurol. 2012;259(9):1923-8.
Zoccolella S, Simone IL, Capozzo R, Tortelli R, Leo A, D’Errico E, et al. An exploratory study of serum urate levels in patients with amyotrophic lateral sclerosis. J Neurol. 2011;258(2):238-43.
Squadrito GL, Cueto R, Splenser AE, Valavanidis A, Zhang H, Uppu RM, et al. Reaction of uric acid with per-oxynitrite and implications for the mechanism of neuroprotection by uric acid. Arch Biochem Biophys. 2000;376 (2):333-7.