Sex- and Laterality-Specific Associations Between Serum Uric Acid-to-Creatinine Ratio and Gait Parameters in Parkinson's Disease.

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ObjectiveUric 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.MethodsSeventy-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.ResultsThe 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 ConclusionThe 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.

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