Objective: To investigate the serum nutritional markers in patients with isolated REM sleep behavior disorders (iRBD) and evaluate their associations with the risk of phenoconversion to α-synucleinopathies.
Background: Previous studies have suggested that nutritional and metabolic alterations are involved in the pathogenesis of α-synucleinopathies. However, the nutritional changes in isolated REM sleep behavior disorder (iRBD), the prodromal stage of ɑ-synucleinopathies, and their relationship to phenoconversion remain unexplored.
Method: 148 patients with video-polysomnograph (vPSG)-confirmed iRBD and 142 age- and sex-matched healthy controls (HCs) were enrolled. 138 patients with iRBD were prospectively followed up over an average duration of 3.79 years and 35 have converted to a defined α-synucleinopathy. Serum nutritional markers, including uric acid (UA), fasting blood glucose (FBG), homocysteine (Hcy), and lipid profiles, were measured at baseline.
Results: Compared with HCs, patients with iRBD exhibited significantly lower serum UA (odds ratio [OR] 0.994, 95% confidence interval [CI] 0.990–0.999, p = 0.010) and FBG (OR 0.669, 95% CI 0.496–0.902, p = 0.008). Competing-risk regression analysis revealed that lower serum UA (hazard ratio [HR] 0.992, 95% CI 0.985–0.998, p = 0.013), higher Hcy (HR 1.070, 95% CI 1.028–1.113, p = 0.001), and higher FBG (HR 1.477, 95% CI 1.081–2.017, p = 0.014) were associated with an increased risk of conversion to dementia.
Conclusion: Lower serum UA and FBG levels are potential risk factors for iRBD. Furthermore, distinct markers, including lower serum UA levels and elevated Hcy and FBG levels, were associated with an increased risk of dementia conversion. Our findings suggest a potential role for nutritional markers as valuable predictors of specific phenoconversion outcomes in patients with iRBD.
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To cite this abstract in AMA style:
H. Zhang, Y. Zang, T. Wang, Y. Li, Y. Yuan, Y. Cai, C. Piu, W. Mao. Serum Nutritional Biomarkers Associated with Isolated REM Sleep Behavior Disorder and α-synucleinopathy Phenoconversion [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/serum-nutritional-biomarkers-associated-with-isolated-rem-sleep-behavior-disorder-and-%ce%b1-synucleinopathy-phenoconversion/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/serum-nutritional-biomarkers-associated-with-isolated-rem-sleep-behavior-disorder-and-%ce%b1-synucleinopathy-phenoconversion/