Get access

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

Authors

  • Seung Hun Lee MD,

    1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Mi Jung Kim MD,

    1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Beom-Jun Kim MD,

    1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Sung Reul Kim RN,

    1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Sail Chun MD, PhD,

    1. Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Jin Sook Ryu MD, PhD,

    1. Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Ghi Su Kim MD, PhD,

    1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Myoung Chong Lee MD, PhD,

    1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    Search for more papers by this author
  • Jung-Min Koh MD, PhD,,

    Corresponding author
    1. Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    • Jung-Min Koh, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, Seoul 138-736, Republic of Korea===

      Sun Ju Chung, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, Seoul 138-736, Republic of Korea===

    Search for more papers by this author
  • Sun Ju Chung MD, PhD

    Corresponding author
    1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    • Jung-Min Koh, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, Seoul 138-736, Republic of Korea===

      Sun Ju Chung, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, Seoul 138-736, Republic of Korea===

    Search for more papers by this author

  • Potential Conflict of interest: Nothing to report.

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 B12 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

Ancillary