Francesc Orfila Pernas1,2, Marina Pou Gimenez¹, Cesar Diaz-Torne³, Enrique Calvo Aranda4
¹ Institut Català de la Salut, EAP Encants, Barcelona, Spain ² IDIAP Jordi Gol, Barcelona, Spain ³ Hospital de la Santa Creu i Sant Pau, Barcelona, Spain 4 Hospital Universitario HM Sanchinarro, Madrid, Spain
Background: It has been demonstrated that hyperuricemia protects from Parkinson’s disease (PD), but this relation is controversial in patients with gout. Inflammatory properties of urate monosodium(UMS) crystals deposition that appears when uric acid(UA) levels exceed its solubility faces antioxidant and neuroprotective features of soluble UA. Both, UMS crystals deposition and hyperuricemia coexist in gouty patients. Research question: Is there any association between gout and Parkinson’s disease?
Methods: The present study is a primary care based matched case-control study, carried out using an electronic clinical record database from the city of Barcelona, Spain. The database contains anonymous data from more than 1 million patients. Persons over 40 years old were studied. All patients diagnosed of PD, or taking high specific anti-Parkinson’s drugs, between 2006 and 2016 were included in the analyzes. We randomly selected four controls for each case, matched by gender and age. Retrospective data of risk factors were also collected for each individual (diagnose of gout, diabetes mellitus, hypertension, high cholesterol blood levels and tobacco consumption prior to the PD diagnose), as well as gender and age. A multivariate logistic regression model was used to evaluate the association of gout and PD, adjusted by the presence of other risk factors. Adjusted Odds Ratios (aOR) and their 95%CI are provided.
Results: 21,789 patients with a PD diagnose and 87,156 controls. Mean age was 75.5 (SD 10.9) years. 55.6% were females.
Conclusions: Gout shows a protective effect on the development of Parkinson’s disease, pointing that the antioxidant and neuroprotective effect of UA seems to overcome its inflammatory properties in gouty patients.