Euser S M, Hofman A, Westendorp R G J, Breteler Monique M B
Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
Brain. 2009 Feb;132(Pt 2):377-82. doi: 10.1093/brain/awn316. Epub 2008 Nov 26.
Uric acid is a risk factor of cardiovascular disease, as well as a major natural antioxidant, prohibiting the occurrence of cellular damage. The relation between uric acid and cognitive decline, in which both vascular mechanisms and oxidative stress are thought to play a role, is unknown. Therefore we assessed the relation between serum uric acid levels and the risk of subsequent dementia in a prospective population-based cohort study among 4618 participants aged 55 years and over. Additionally, we investigated the relation between serum uric acid and cognitive function later in life (on average 11.1 years later) in a subsample of 1724 participants who remained free of dementia during follow-up. All analyses were adjusted for age, sex and cardiovascular risk factors. Our data showed that only after correcting for several cardiovascular risk factors, higher serum uric acid levels were associated with a decreased risk of dementia (HR, adjusted for age, sex and cardiovascular risk factors, 0.89 [95% confidence interval (CI) 0.80-0.99] per standard deviation (SD) increase in uric acid). In participants who remained free of dementia, higher serum uric acid levels at baseline were associated with better cognitive function later in life, for all cognitive domains that were assessed [adjusted difference in Z-score (95% CI) per SD increase in uric acid 0.04 (0.00-0.07) for global cognitive function; 0.02 (-0.02 to 0.06) for executive function; and 0.06 (0.02-0.11) for memory function], but again only after correcting for cardiovascular risk factors. We conclude that notwithstanding the associated increased risk of cardiovascular disease, higher levels of uric acid are associated with a decreased risk of dementia and better cognitive function later in life.
尿酸是心血管疾病的一个风险因素，同时也是一种主要的天然抗氧化剂，可防止细胞损伤的发生。尿酸与认知功能衰退之间的关系尚不清楚，一般认为血管机制和氧化应激在其中都发挥了作用。因此，我们在一项基于人群的前瞻性队列研究中，对4618名年龄在55岁及以上的参与者进行了评估，以探讨血清尿酸水平与随后发生痴呆症风险之间的关系。此外，我们还在1724名随访期间未患痴呆症的参与者子样本中，研究了血清尿酸与晚年认知功能（平均11.1年后）之间的关系。所有分析均对年龄、性别和心血管风险因素进行了校正。我们的数据表明，只有在校正了多个心血管风险因素之后，较高的血清尿酸水平才与较低的痴呆症风险相关（校正年龄、性别和心血管风险因素后的风险比，尿酸每增加一个标准差（SD）为0.89 [95%置信区间（CI）0.80 - 0.99]）。在未患痴呆症的参与者中，基线时较高的血清尿酸水平与晚年更好的认知功能相关，在所评估的所有认知领域中都是如此[尿酸每增加一个SD，全球认知功能的Z评分校正差异（95% CI）为0.04（0.00 - 0.07）；执行功能为0.02（-0.02至0.06）；记忆功能为0.06（0.02 - 0.11）]，但同样也是在校正了心血管风险因素之后。我们得出结论，尽管尿酸水平升高与心血管疾病风险增加相关，但较高水平的尿酸与较低的痴呆症风险以及晚年更好的认知功能相关。
