Homocysteine-lowering therapy or antioxidant therapy for bone loss in Parkinson's disease.
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.
Lee
Seung Hun
SH
Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Mi Jung
MJ
Kim
Beom-Jun
BJ
Kim
Sung Reul
SR
Chun
Sail
S
Ryu
Jin Sook
JS
Kim
Ghi Su
GS
Lee
Myoung Chong
MC
Koh
Jung-Min
JM
Chung
Sun Ju
SJ
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
D000975:Antioxidants; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D006710:Homocysteine; D008063:Thioctic Acid