Correlation Study About The Effect Of Homocysteine And Lipid On Mutiple System Atrophy

Background and ObjectivesMultiple system atrophy(MSA) is a rare adult-onset neurodegenerative disease. It progress faster and early clinical manifestations are similar as other neurological diseases, so diagnose and treatment in initial stage of the disease are limited, thus providing more diagnostic criteria and seeking a breakthrough point of therapy is particularly important. Homocysteine(Hcy) may participated in oxidative stress damage, DNA damage, apoptosis factor activation and mitochondrial dysfunction, and is associated with neurodegenerative diseases. Lipid involved in stabilizing the cell membrane, inhibition of oxidative stress and regulation of mitochondrial function, and previous studies have demonstrated lipid levels were associated with the prevalence of MSA, but the relationship between MSA subtypes and lipid was unclear.In this study, we compared the differences of Hcy and total cholesterol(TCHO), triglyceride(TG), low density lipoprotein cholesterin(LDL-C), high density lipoprotein cholesterin(HDL-C) levels between MSA patients and healthy controls to explore whether Hcy and lipidare the onset biomarkers of MSA, and search the differences of Hcy and lipid among different MSA subtypes. MethodsAll MSA patients and healthy controls were consecutively enrolled from January 2011 to March 2015 in department of Neurology, the First Affiliated Hospital of Zhengzhou University. Demographic features and biochemical results of Hcy, vitamin B12, folate and TCHO, TG, LDL-C, HDL-C were collected in detail. The t tests and c2 tests were used to compare the demographic features and Hcy, vitamin B12, folate, lipid levels between MSA patients and controls. Using LSD-t tests compare the Hcy, vitamin B12, folate and lipid levels among subtypes of MSA patients. The relevance between lipid levels and onset age, disease duration and H&Y stage were calculated by Spearman correlation coefficients. The association between MSA and the levels of Hcy, vitamin B12, folate and lipid were analyzed using binary logistic regression. Multinomial logistic regression was conducted to search the predisposition of MSA in different lipid levels. P < 0.05 was considered statistically significant. ResultsParticipants include 195 MSA patients and 195 age- and gender-matched controls with no neurological diseases. All subjects underwent lipid testing, 173 patiens and 179 healthy controls underwent Hcy, folate and vitamin B12 testing. Patients Hcy levels were significantly higher than controls(P < 0.05), especially in male population. Hcy levels of MSA-C patients were significantly higher than controls(P < 0.05). Multivariate analysis shows the correlation of Hcy and MSA(P < 0.05), OR was 1.05(95% CI = 1.01 ~ 1.09). The levels of TCHO, TG, LDL-C were significantly lower in MSA patients than in controls(P < 0.05). TCHO and TG levels were significantly lower in MS?-P patients than controls. After adjusting for confounders, the OR was 0.31(95% CI = 0.15 ~ 0.65, P < 0.05) for MSA patients in the highest quartile of TG and OR=0.38(95%CI=0.17 ~ 0.83, P < 0.05) for those in the highest quartile of HDL-C, compared with the lowest quartiles. And HDL-C level was in a significantly positive correlation with onset age(r=0.15, P < 0.05).ConclutionThe increased level of Hcy maybe is associated with MSA, especially in MSA-C patients and male. The decreased levels of TG or HDL-C may be associated with prevalence of MSA, and the lower levels of HDL-C, the earlier of onset age.