ABSTRACT
Background: The pathogenic mechanism of AmyotrophicLateral Sclerosis (ALS) remains indistinct. However, increasingevidence has indicated that uric acid (UA) may play aprotective role in the pathogenesis of ALS as well as in that ofother neurodegenerative diseases. Low serum uric acid (UA)levels are found in many neurodegenerative diseases. It hasbeen suggested that oxidative stress is one of the pathogenicmechanism for amyotrophic lateral sclerosis (ALS), and thusantioxidants such as UA that could reduce oxidative stressmight be beneficial in the early detection of progression of thedisease. The objective of this study was to prospectivelyinvestigate serum UA levels in ALS patients and to relate themto disease process and disease status.Methods: ALS patients and healthy controls who wereindividually well-matched for age, sex, and body mass index(BMI) underwent blood testing for serum UA levels, andanalyzed whether UA levels were correlated with the diseasestatus of the patients, severity of the disease as defined by theALS Functional Rating Scale-Revised (ALSFRS-R) andduration of illness.Results: The study included 37 ALS patients and 37 matchedcontrols. The serum UA level was lower in the ALS patients(4.29 mg/dl ±1.35 mg/dL, mean±SD) than in the controls (6.26mg/dL±1.22 mg/dL; p<0.001). Female ALS patients hadsignificantly lower (3.55 mg/dl± 0.89 mg/dL) than Male ALSpatients (4.53 mg/dl±1.4 mg/dL; p<0.05). Among the ALSpatients, the lower level of UA acid was strongly correlated withthe rate of disease progression (decrease in ALSFRS-R score)p<0.001. Uric acid level is inversely correlated with the durationof the disease (r -0.32). Respondents with smoking historygroup showed more likely to develop ALS than therespondents with no smoking history.Conclusion: ALS patients had lower serum UA levels than didhealthy individuals and it is significantly lower in Female ALSpatients than Male ALS patients. Uric acid levels in ALS werepositively correlated with the ALSFRS-R (severity) andnegatively associated with duration of illness. UA levels couldbe considered a biomarker of disease progression in the earlyphase in ALS patients