title: Homocysteine-lowering therapy or antioxidant therapy for bone loss in Parkinson's disease.
abstract: We investigated whether homocysteine (Hcy)- lowering therapy or an antioxidant prevented bone loss in Parkinson's disease (PD) patients taking levodopa. Forty-two PD patients with low bone mineral density (BMD) taking levodopa were randomly assigned to Hcy-lowering therapy (5 mg folate and 1500 microg vitamin B(12) daily), alpha-lipoic acid (alpha-LA) therapy (1200 mg daily), or control groups. Primary outcomes were BMD changes from baseline to 12 months. Secondary outcomes were changes in Hcy level, and C-telopeptide (CTX) levels at 12 months. Forty-one patients completed the study. Hcy-lowering therapy resulted in significantly greater BMD changes at the lumbar spine (4.4%), total femur (2.8%), and femur shaft (2.8%) than control (P = 0.005-0.023). BMD changes in the alpha-LA therapy group were similar to those of the control group, but changes at the trochanter (4.6%) were significantly greater in the alpha-LA therapy group than in the control group after adjustment for body mass index changes. Hcy concentrations decreased to 35.2% +/- 13.4% in the Hcy-lowering therapy group, but increased in other groups. Serum CTX levels at 12 months tended to be lower in the Hcy-lowering group (0.442 +/- 0.024 ng/mL) than control group (0.628 +/- 0.039 ng/mL) (P = 0.159). This small trial suggests that Hcy-lowering therapy may prevent bone loss in PD patients taking levodopa.
authors: Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Seung Hun
authors: SH
authors: Lee
authors: Mi Jung
authors: MJ
authors: Kim
authors: Beom-Jun
authors: BJ
authors: Kim
authors: Sung Reul
authors: SR
authors: Kim
authors: Sail
authors: S
authors: Chun
authors: Jin Sook
authors: JS
authors: Ryu
authors: Ghi Su
authors: GS
authors: Kim
authors: Myoung Chong
authors: MC
authors: Lee
authors: Jung-Min
authors: JM
authors: Koh
authors: Sun Ju
authors: SJ
authors: Chung
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry / Q000379:methods; D000975:Antioxidants / Q000627:therapeutic use*; D018488:Bone Demineralization, Pathologic / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D015519:Bone Density / Q000187:drug effects; D024042:Collagen Type I / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D010455:Peptides / Q000378:metabolism; D008063:Thioctic Acid / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D006710:Homocysteine; D008063:Thioctic Acid