Homocysteine-lowering therapy or antioxidant therapy for bone loss in Parkinson's disease

✍ Scribed by Seung Hun Lee; Mi Jung Kim; Beom-Jun Kim; Sung Reul Kim; Sail Chun; Jin Sook Ryu; Ghi Su Kim; Myoung Chong Lee; Jung-Min Koh; Sun Ju Chung

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 122 KB
• Volume: 25
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.22866

✦ Synopsis

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 μg vitamin B~12~ daily), α‐lipoic acid (α‐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 α–LA therapy group were similar to those of the control group, but changes at the trochanter (4.6%) were significantly greater in the α–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. © 2009 Movement Disorder Society