Study On The Relationship Between Homocysteine,Uric Acid Level And Cognitive Impairment In Patients With Parkinson’s Disease

Objective To investigate the relationship between plasma homocysteine(HCY),folic acid,vitamin B12,uric acid(UA)level and cognitive impairment in patients with Parkinson’s disease(PD),and find the risk factors of cognitive impairment in PD.Methods Between March 2015 to March 2016,we enrolled 84 patients with a diagnosis of PD and 41 normal controls in the Second Affiliated Hospital of Soochow University.We recorded detailed information of basic demographics,including ages,educational level,course of disease and medication,and also examed plasma HCY,folic acid,vitamin B12,UA and creatinine of all the patients.According to Montreal Cognitive Assessment(MoCA),PD patients were divided into two groups: cognitive impairment(n=37)group and non-cognitive impairment group(n = 47).We did the comparison and analysis of basic data and clinical symptoms in three groups.Results1 、 Comparison of general data: There were no significant differences in age and gender among the three groups.In PD patients,there were significant differences in education level,MoCA,course of disease,UPDRS III and LED(P<0.05)between cognitive impairment group and non-cognitive impairment group,unless H & Y stage.There were significant differences in educational level and MoCA between PD cognitive impairment group and control group.However,there were no significant differences in the educational level and MoCA between PD non-cognitive impairment group and control group.2 、 At first there was no significant difference in creatinine level among the three groups(P <0.05).Then there were significant differences in plasma HCY,folic acid and UA levels among three groups(P <0.05),while there was no statistically significant in Vitamins B12 level.Meanwhile there were no significant differences in plasma levels of HCY,folic acid,Vitamins B12 and UA between PD non-impairment group and normal controls(P> 0.05).3、The cognitive impairment of PD patients was correlated with the level of education,course of disease,LED,UPDRS III,H & Y stage,HCY,folic acid,VitB12 and UA levels,but not with gender,age and creatinine level.Correction through gender,education level,age,duration,LED,UPDRS III,H & Y stage,we found that the cognitive impairment of PD patients was correlated with the levels of HCY,folic acid and UA in plasma,negatively correlated with HCY level,and positively correlated with folic acid and UA levels.4、Binary logistic regression analysis showed that the level of education(OR = 1.169,P <0.05),UPDRS III score(OR = 0.908,P<0.05),HCY(OR = 0.923,P <0.05),folic acid(OR = 1.168,P<0.05),UA(OR = 1.011,P <0.05)were risk factors for cognitive impairment in patients with PD.In this study,age,duration,LED,H & Y stage were not risk factors for PD cognitive impairment.Conclusion The cognitive function of PD patients was positively correlated with the levels of folic acid and UA in plasma,and negatively correlated with HCY level.Education level,UPDRS III score,plasma HCY,folic acid,UA levels were risk factors for PD cognitive impairment.