title: Prognostic Role of Serum Levels of Uric Acid in Amyotrophic Lateral Sclerosis.
abstract: OBJECTIVE
  It has been suggested that oxidative stress is one of the pathomechanisms underlying amyotrophic lateral sclerosis (ALS), and thus antioxidants such as uric acid (UA) that could reduce oxidative stress might be beneficial in the prevention or treatment of this disease. The objective of this study was to prospectively investigate serum UA levels in Korean ALS patients and to relate them to disease progression.
  
  
  METHODS
  ALS patients and healthy controls who were individually well-matched for sex, age, and body mass index (BMI) underwent blood testing for serum UA levels, and analyzed whether UA levels were correlated with the disease status of the patients, as defined by the ALS Functional Rating Scale-Revised (ALSFRS-R).
  
  
  RESULTS
  The study included 136 ALS patients and 136 matched controls. The UA level was lower in the ALS patients (4.50±1.17 mg/dL, mean±SD) than in the controls (5.51±1.22 mg/dL; p<0.001). Among the ALS patients, the level of UA acid was inversely correlated with the rate of disease progression (decrease in ALSFRS-R score). Kaplan-Meier analysis revealed that a better survival rate was more strongly correlated with top-tertile levels of serum UA than with bottom-tertile levels (log-rank test: p=0.035).
  
  
  CONCLUSIONS
  ALS patients had lower serum UA levels than did healthy individuals. UA levels in ALS were negatively correlated with the rate of disease progression and positively associated with survival, suggesting that UA levels contribute to the progression of ALS. UA levels could be considered a biomarker of disease progression in the early phase in ALS patients.
authors.affiliation: Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Oh
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Soojeong
authors.initials: S
authors.lastname: Baek
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.|Department of Neurology, College of Medicine, Yanbian University Hospital, Yanji, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Piao
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Ki Wook
authors.initials: KW
authors.lastname: Oh
authors.affiliation: Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea. kimsh1@hanyang.ac.kr.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Kim
keywords: amyotrophic lateral sclerosis; oxidative stress; prognosis; survival; uric acid