Objective: To determine changes in serum hepatic biomarker concentrations according to Parkinson’s disease (PD) severity in Peruvian adults.

Background: PD is a progressive neurodegenerative disorder. Emerging evidence suggests a potential liver-brain axis involvement in its pathogenesis, but data from Latin American populations remain limited.

Method: A prospective cross-sectional study was conducted in 90 patients with confirmed PD in Lima, Peru (2025). Disease severity was staged using the Hoehn and Yahr (H&Y) scale. Fasting serum concentrations of ten hepatic markers (AST, ALT, GGT, ALP, total/direct/indirect bilirubin, total protein, albumin, and globulins) were quantified by standardized spectrophotometry. The Kruskal-Wallis test compared biomarker concentrations across H&Y stages I-IV.

Results: Mean age was 66.3±11.7 years (70% male). H&Y distribution: Stage 1 (n=16, 17.8%), Stage 2 (n=31, 34.4%), Stage 3 (n=30, 33.3%), and Stage 4 (n=13, 14.4%). Descriptive analysis showed variability in mean biomarker concentrations across stages (AST ranged from 19.8±5.9 U/L in Stage 1 to 34.1±18.2 U/L in Stage 4). Inferential statistics revealed no significant differences in most hepatic markers across PD severity groups (p>0.05). However, a statistically significant difference was identified for direct bilirubin (BILD) levels among the four severity stages (p=0.020).

Conclusion: Although the overall hepatic profile showed no significant alterations with advancing PD severity in this Peruvian cohort, the specific finding of differential direct bilirubin concentrations warrants further investigation. This may reflect subclinical hepatic involvement in bilirubin conjugation or excretion, potentially linked to systemic oxidative stress mechanisms in advanced PD. Longitudinal studies are needed to validate these findings and explore their pathophysiological relevance.

References: Gatarek P, Sekrecka A, Kaluzna-Czaplinska J, Bjørklund G. Plasma metabolic alterations in patients with Parkinson’s disease. J Med Food. 2022;25(3):267-274.

Choe CU, Petersen E, Lezius S, et al. Association of lipid levels with motor and cognitive function and decline in advanced Parkinson’s disease in the Mark-PD study. Parkinsonism Relat Disord. 2021;85:5-10.

Sigawi T, Ilutz Y, Simchovitz E, et al. Investigating the relationship between chronic liver cirrhosis and parkinsonism: A comparative analysis and suggested diagnostic scheme. J Clin Med. 2024;13(2):456.

Ikenaka Y, Kondo T, Saito Y, et al. Decreased liver enzymes reflect decreased vitamin B6 levels in patients with Parkinson’s disease. J Neural Transm. 2024;131(1):45-52.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hepatic-biomarker-profile-across-parkinsons-disease-severity-stages-in-a-peruvian-cohort/