Endothelial dysfunction and hyperhomocysteinemia in Parkinson's disease: flow-mediated dilation study.

Abstract

BACKGROUND: Levodopa (l-dopa) therapy in Parkinson's disease (PD) increases serum

homocysteine levels because of its metabolism via catechol O-methyltransferase,

which may lead to endothelial dysfunction. METHOD: We enrolled 40 PD patients

treated with l-dopa, 33 PD patients treated with l-dopa/entacapone, 22 untreated

PD and 30 controls, and compared the flow-mediated dilation in these subjects.

RESULTS: The flow-mediated dilation was significantly lower in PD patients with

l-dopa (6.0 +/- 1.8%) than in those with l-dopa/entacapone (7.2 +/- 1.1%, P =

0.03), untreated PD patients (7.8 +/- 1.2%, P < 0.05), and controls (8.5 +/-

2.9%, P < 0.05). The homocysteine level was significantly higher in PD patients

with l-dopa than in other groups. In a multivariate logistic regression model,

the uppermost homocysteine quartile was an independent predictor of the lowest

tertile of flow-mediated dilation (odds ratio, 6.33; 95% confidence interval,

1.61-26.65; P = 0.012). CONCLUSIONS: Our findings indicate that endothelial

dysfunction may be associated with chronic l-dopa treatment in patients with PD.