Elevated serum urate levels in gout provide neuroprotective effects, reducing the risk for Parkinson disease (PD) in both men and women, especially over the age of 75, according to study findings published in Joint Bone Spine.

Prior research on PD suggest that serum urate protects against PD development; however, the data are limited regarding the relationship between gout and PD. The objective of this study was to confirm whether serum urate has a neuroprotective effect in PD in patients with gout.

The researchers obtained deidentified data for 1,520,934 patients from electronic medical records from the public primary health care system database in Barcelona. They selected 17,629 patients over age 40 with a new diagnosis of PD using ICD-10 codes. Only 669 of these 17,629 patients with PD had gout. The researchers calculated a 0.68% prevalence of PD and a 2.54% prevalence of gout in this urban Mediterranean population.


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A total of 70,516 control individuals — 4 age- and gender-matched control individuals for each of the 17,629 patients with PD were selected. The researchers recorded risk factors for PD for everyone in the control group and statistically analyzed the relationship between PD and gout before and after adjusting for these PD risk factors.

Prior to adjusting for PD risk factors, the researchers noted a probability of an association between PD and gout (odds ratio [OR], 0.85; 95% CI, 0.78-0.93). After separating the patients by age into groups younger and older than 75 years of age, the researchers believed gout had a neuroprotective effect in preventing the likelihood of PD in individuals older than 75 years of age (OR, 1.08; 95% CI, 0.93-1.26 vs OR, 0.77; 95% CI, 0.70-0.86).

Adjusting for PD risk factors resulted in similar trends (adjusted OR [aOR], 0.83; 95% CI, 0.76-0.91) indicating an association between PD and gout and age (aOR, 0.99; 95% CI, 0.85-1.16) and (OR, 0.77; 95% CI, 0.70-0.86), for those younger and older than 75 years of age, respectively. Dyslipidemia, hypertension, and diabetes increased risk for PD, while tobacco consumption decreased risk for PD.

Study limitations included the retrospective design using an electronic database that may have contained coding mistakes and misdiagnoses. The researchers also did not analyze the effects of urate reducing therapies on PD.

A “rheumatologist should be cautious when reducing [serum urate] levels too much (<3 mg/dL) for a long time,” the researchers recommended. For the neurologist, “… this data does not exclude a beneficial effect of urate in preventing PD,” they concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Pou MA, Orfila F, Pagonabarraga J, Ferrer-Moret S, Corominas H, Diaz-Torne C. Risk of Parkinson’s disease in a gout Mediterranean population: A case-control study. Joint Bone Spine. Published online April 30, 2022. doi:10.1016/j.jbspin.2022.105402



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