AUTHOR=Quan Yuxin , Xu Jisen , Xu Qing , Guo Zhiqing , Ou Ruwei , Shang Huifang , Wei Qianqian TITLE=Association between the risk and severity of Parkinson’s disease and plasma homocysteine, vitamin B12 and folate levels: a systematic review and meta-analysis JOURNAL=Frontiers in Aging Neuroscience VOLUME=Volume 15 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1254824 DOI=10.3389/fnagi.2023.1254824 ISSN=1663-4365 ABSTRACT=Background: Parkinson's disease (PD) is recognized as the second most prevalent progressive neurodegenerative disease among the elderly. However, the relationship between PD and plasma homocysteine (Hcy), vitamin B12 and folate has yielded inconsistent results in previous studies. Hence, in order to address this ambiguity, we conducted a meta-analysis to summarize the existing evidence.Methods: Suitable studies published prior to May 2023 were identified by searching PubMed, EMBASE, Medline, Ovid and Web of Science. The methodological quality of eligible studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Meta-analysis and publication bias were then performed using R version 4.3.1.The results of our meta-analysis, consisting of case-control studies and crosssectional study, showed that PD patients had lower folate and vitamin B12 levels (SMD [95%CI]: -0.30[-0.39, -0.22], P < 0.001 for Vitamin B12; SMD [95%CI]: -0.20 [-0.28, -0.13], P < 0.001 for folate), but a significant higher Hcy level (SMD [95%CI]: 0.86 [0.59, 1.14], P < 0.001) than healthy people. Meanwhile, PD was significantly related to hyperhomocysteinemia (SMD [95%]: 2.02 [1.26, 2.78], P < 0.001) rather 2 / 20 than plasma Hcy below 15 μmol/L (SMD [95%]: -0.31 [-0.62, 0.00], P = 0.05).Subgroup analysis revealed associations between Hcy level of PD patients and region (P = 0.03), age (P = 0.03), levodopa therapy (P = 0.03), Hoehn & Yahr stage (P < 0.001) and cognitive impairment (P < 0.001). However, gender (P = 0.38) and sample size (P = 0.49) were not associated.Hcy, vitamin B12 and folic acid potentially predict the onset and development of PD. Additionally, multiple factors were linked to Hcy levels in PD patients. Further studies are needed to comprehend their roles in PD.