Gout and risk of Parkinson disease

Background: Several reports suggest that higher levels of serum uric acid are associated with a lower risk of Parkinson disease (PD). None of these studies, however, evaluated the potential association between gout, a condition characterized by hyperuricemia, and the risk of PD. Objective: To estimate prospectively the association between gout diagnosis and the risk of PD. Methods: We conducted a case-control study nested in the General Practice Research Database, a computerized database that gathers information on more than 3 million Britons followed up by their general practitioners. PD cases occurring between January 1995 and December 2001 were identified, and matched with up to 10 controls by sex, age, practice, and start of follow-up. We obtained information on history of gout and use of anti-gout medication using the computerized medical records. Results: During the study period, we identified 1,052 PD cases and 6,634 controls. Individuals with previous history of gout had a lower risk of developing PD (OR 0.69, 95% CI 0.48, 0.99). This association was evident among men (OR 0.60, 95% CI 0.40, 0.91) but not among women (OR 1.26, 95% CI 0.57, 2.81; p for interaction: 0.11). Initiation of anti-gout medication was associated with a lower risk of PD (OR 0.57, 95% CI 0.19, 1.70). Conclusion: Gout is associated with a lower risk of Parkinson disease (PD). Our findings provide additional support for a potential link between uric acid and PD. Further research is required to explore a potential effect modification by sex. GLOSSARY: GPRD = General Practice Research Database; PD = Parkinson disease.

[1]  S. Przedborski,et al.  Oxidative Stress in Parkinson's Disease , 2008, Annals of the New York Academy of Sciences.

[2]  M. Weisskopf,et al.  Plasma urate and risk of Parkinson's disease. , 2007, American journal of epidemiology.

[3]  Hassan Fouayzi,et al.  Validity of gout diagnoses in administrative data. , 2007, Arthritis and rheumatism.

[4]  Albert Hofman,et al.  Serum cholesterol levels and the risk of Parkinson's disease. , 2006, American journal of epidemiology.

[5]  M. Hernán,et al.  Nonsteroidal anti-inflammatory drugs and the incidence of Parkinson disease , 2006, Neurology.

[6]  P. Jenner,et al.  3-Nitrotyrosine-dependent dopaminergic neurotoxicity following direct nigral administration of a peroxynitrite but not a nitric oxide donor , 2006, Brain Research.

[7]  J. Robins,et al.  Discussion on "Statistical Issues Arising in the Women's Health Initiative" , 2005 .

[8]  Garnet L Anderson,et al.  Statistical Issues Arising in the Women's Health Initiative , 2005, Biometrics.

[9]  A. Hofman,et al.  Serum uric acid levels and the risk of Parkinson disease , 2005, Annals of neurology.

[10]  N. Wood,et al.  Molecular pathogenesis of Parkinson's disease. , 2005, Human molecular genetics.

[11]  Hyon K. Choi,et al.  Gout: epidemiology and lifestyle choices , 2005, Current opinion in rheumatology.

[12]  S. Cuzzocrea,et al.  Uric acid protects against secondary damage after spinal cord injury. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[13]  W. Bilker,et al.  Gout epidemiology: results from the UK General Practice Research Database, 1990–1999 , 2005, Annals of the rheumatic diseases.

[14]  M. Hernán,et al.  A prospective study of alcoholism and the risk of Parkinson’s disease , 2004, Journal of Neurology.

[15]  H. Jick,et al.  Omeprazole, other antiulcer drugs and newly diagnosed gout. , 2003, British journal of clinical pharmacology.

[16]  Corri Black,et al.  Validity of the General Practice Research Database , 2003, Pharmacotherapy.

[17]  R. Anderson,et al.  Dopamine and Uric Acid Act as Antioxidants in the Repair of DNA Radicals: Implications in Parkinson's Disease , 2003, Free radical research.

[18]  Miguel A Hernán,et al.  A meta‐analysis of coffee drinking, cigarette smoking, and the risk of Parkinson's disease , 2002, Annals of neurology.

[19]  M. Mattson,et al.  Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neurons in models of Parkinson's disease , 2002, Journal of neurochemistry.

[20]  W. Willett,et al.  Prospective study of caffeine consumption and risk of Parkinson's disease in men and women , 2001, Annals of neurology.

[21]  P. Chou,et al.  Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. , 2000, The Journal of rheumatology.

[22]  K. Suzuki,et al.  Risk factors for the incidence of hyperuricaemia: a 6-year longitudinal study of middle-aged Japanese men. , 1999, International journal of epidemiology.

[23]  S. Kono,et al.  Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males , 1999, British Journal of Nutrition.

[24]  S. Gutthann,et al.  Use of the UK General Practice Research Database for pharmacoepidemiology. , 1998, British journal of clinical pharmacology.

[25]  O. Bagasra,et al.  Prevention of experimental allergic encephalomyelitis by targeting nitric oxide and peroxynitrite: implications for the treatment of multiple sclerosis. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[26]  D. Morens,et al.  Observations on serum uric acid levels and the risk of idiopathic Parkinson's disease. , 1996, American journal of epidemiology.

[27]  W. H. Church,et al.  Uric acid is reduced in the substantia nigra in parkinson's disease: Effect on dopamine oxidation , 1994, Brain Research Bulletin.

[28]  F. Wolfe,et al.  The misdiagnosis of gout and hyperuricemia. , 1991, The Journal of rheumatology.

[29]  W. James,et al.  Effects of smoking and vitamin E on blood antioxidant status. , 1991, The American journal of clinical nutrition.

[30]  K. Davies,et al.  Uric acid-iron ion complexes. A new aspect of the antioxidant functions of uric acid. , 1986, The Biochemical journal.

[31]  J. Lellouch,et al.  The relationships between smoking and levels of serum urea and uric acid. Results of an epidemiological survey. , 1969, Journal of chronic diseases.

[32]  D. Mccarty,et al.  Identification of urate crystals in gouty synovial fluid. , 1961, Annals of internal medicine.

[33]  J. V. F. Valls,et al.  Estudio caso-control de marcadores de estrés oxidativo y metabolismo del hierro plasmático en la enfermedad de Parkinson , 2001 .

[34]  Centron de Investigación,et al.  Case-control Study of Oxidative Stress and Plasma Iron Metabolism Markers in Parkinson's Disease , 2001 .

[35]  L. G. García Rodríguez,et al.  Use of the UK General Practice Research Database for pharmacoepidemiology. , 1998, British journal of clinical pharmacology.