Hongwei Guo, Kangmei Shao, Yujie Bu, Wenjuan Li, Jianping Hu, Yanfang Zhang, Jianxiong Li
The findings indicate that sex and motor symptom laterality may jointly shape how UA/Cr relates to spatial gait performance in PD. The positive association was most pronounced in men with right-dominant motor symptoms, while among female patients with left- dominant motor symptoms, a relatively weaker negative correlation was observed. Given the exploratory nature and modest sample size, these results should be interpreted cautiously and warrant confirmation in larger, longitudinal studies to clarify subgroup-specific neuroprotective effects of uric acid.
OBJECTIVE: Uric acid is believed to potentially have neuroprotective effects in Parkinson's disease (PD), but its link to gait performance and potential moderation by sex or motor symptom laterality remains unclear. This study explored whether the association between the serum uric acid-to-creatinine (UA/Cr) ratio and spatial gait parameters varies by sex and the dominant side of motor symptoms in PD patients.
METHODS: Seventy-seven patients with early-stage PD were assessed. Concurrently, spatial gait parameters including step height and step length were measured, as well as serum UA/Cr levels. Conditional process analysis (PROCESS Model 2) examined whether sex and motor symptom laterality jointly moderated the UA/Cr-gait relationship, controlling for age, body mass index, disease duration, levodopa equivalent dose, and motor severity. Subgroup-specific conditional effect analyses further clarified these associations.
RESULTS: The dual-moderation model explained 54.45% of the variance in step height (FDR-adjusted p = 0.0204). Associations between UA/Cr and gait were highly subgroup-dependent. Men with right-dominant motor symptoms showed a significant positive relationship between UA/Cr and both step height and step length (p < 0.05). Conversely, women with left-dominant symptoms exhibited a negative association between UA/Cr and step height (p = 0.0258). Other sex-laterality subgroups showed no significant associations.
CONCLUSION: The findings indicate that sex and motor symptom laterality may jointly shape how UA/Cr relates to spatial gait performance in PD. The positive association was most pronounced in men with right-dominant motor symptoms, while among female patients with left- dominant motor symptoms, a relatively weaker negative correlation was observed. Given the exploratory nature and modest sample size, these results should be interpreted cautiously and warrant confirmation in larger, longitudinal studies to clarify subgroup-specific neuroprotective effects of uric acid.