| Research Background: Multiple system atrophy is an adult-onset, rarely and fatal disease, whose pathological feature is the alpha-synuclein and clinical manifestations including the progressive autonomic dysfunction, the Parkinson’s disease, and the cerebellar ataxia. With the advent of an aging society and constantly updated diagnostic criteria, the MSA has been paying more and more attentions. At current stage, the mechanism of MSA is still unclear. Some groups based on the basic research suggest that the oxidative stress and mitochondrial dysfunction may result in the MSA. The serum uric acid(UA), which is known as the final product of the Purine metabolism, is a powerful antioxidants and an effective scavenger of the radical. It can prevent the oxidative damage by chelating the metal ions. Some research groups show that both the oxidative stress and the values of UA are associated with the mechanism of diseases AD, ALS, and PD. This thesis is to study the level and value of UA in patients with MSA and discuss the possible effect on future research.Methods: One hundred and one MSA patients were selected as the MSA group and 101 age and sex-matched healthy people as the control group. The UA concentrations and other biochemical indexes were biochemically measured by an enzymatic method and carefully analyzed. By comparing the UA levels for different genders, subtypes, and different levels of certainty of the MSA group with their normal counterparts in the control group, we obtained the differences between these two groups and also discussed possible reasons and factors. The MSA patients were divided into different levels by referencing the values of UA with remedying the possible factors to study the relationships between the value of UA and the risk of MSA by recording the course of MSA. SPSS19.0 is used to analyze the statistics.Results: The serum UA levels of MSA patients((283.74±87.76) μmol/L) were much lower than the controls’((317.86±76.95) μmol/L; t=–2.94, P<0.05). In addition, when the male and female groups were investigated separately, the decrease of serum UA was much significant in the male group compared to the female group(t =–3.88, P<0.01). Furthermore, by comparing different subtypes of the MSA patients with the control group, we found that the serum UA in both P-type and C-type MSA patients were significantly lower than in controls(t=2.92, 2.02;all P<0.05). By comparing different levels of MSA with the control group’s, we obtained that UA levels in both probable MSA patients and possible MSA patients were much lower than in controls’(t =3.13, 2.09;all P<0.05). Comparisons among different subtypes of the MSA patients, such as P-type and C-type, probable patients and possible patients do not have statistical significance(P>0.5). By adjusting for the confound factors, such as age, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatinine, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol, the multiple regression Logistic analysis showed that the numbers of MSA patients in the lowest level UA group(UA<263 μmol/L) were higher than the high level UA group(UA>370.5 μmol/L), though the difference did not reach statistical significance(P>0.05). Nevertheless, the numbers of male MSA patients in the lowest level and the lower level UA groups(UA=263–309 μmol/L) were 11.5 and 10.8 times higher than that in the high level UA group(P=0.001, P=0.003). No obviously linear relation between the level of UA and disease progression was found.Conclusions: The decreased serum UA was closely related with MSA, especially for the male patients. UA can be used as an antioxidant in nervous degenerative diseases, which has a protective effect. |
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