Han Lin, Jia Zhaotong, Cao Chunwei, Liu Zhen, Liu Fuqiang, Wang Lin, Ren Wei, Sun Mingxia, Wang Baoping, Li Changgui, Chen Li
Department of Endocrinology Qilu Hospital of Shandong University, Jinan Gout Laboratory, The Affiliated Hospital of Qingdao University, Qingdao State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.
Medicine (Baltimore). 2017 Sep;96(39):e8195. doi: 10.1097/MD.0000000000008195.
Cognitive impairment has been described in elderly subjects with high normal concentrations of serum uric acid. However, it remains unclear if gout confers an increased poorer cognition than those in individuals with asymptomatic hyperuricemia. The present study aimed at evaluating cognitive function in patients suffering from gout in an elderly male population, and further investigating the genetic contributions to the risk of cognitive function.This study examined the cognitive function as assessed by Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in 205 male gout patients and 204 controls. The genetic basis of these cognitive measures was evaluated by genome-wide association study (GWAS) data in 102 male gout patients. Furthermore, 7 loci associated with cognition in GWAS were studied for correlation with gout in 1179 male gout patients and 1848 healthy male controls.Compared with controls, gout patients had significantly lower MoCA scores [22.78 ± 3.01 vs 23.42 ± 2.95, P = .023, adjusted by age, body mass index (BMI), education, and emotional disorder]. GWAS revealed 7 single-nucleotide polymorphisms (SNPs) associations with MoCA test at a level of conventional genome-wide significance (P < 9.6 × 10). The most significant association was observed between rs12895072 and rs12434554 within the KTN1 gene (Padjusted = 4.2 × 10, Padjusted = 4.7 × 10) at 14q22. The next best signal was in RELN gene (rs155333, Padjusted = 1.3 × 10) at 7q22, while the other variants at rs17458357 (Padjusted = 3.98 × 10), rs2572683 (Padjusted = 8.9 × 10), rs12555895 (Padjusted = 2.6 × 10), and rs3764030 (Padjusted = 9.4 × 10) were also statistically significant. The 7 SNPs were not associated with gout in further analysis (all P > .05).Elderly male subjects with gout exhibit accelerated decline in cognition performance. Several neurodegenerative disorders risk loci were identified for genetic contributors to cognitive performance in our Chinese elderly male gout population. Larger prospective studies of the cognitive performance and genetic analysis in gout subjects are recommended.
认知障碍在血清尿酸浓度处于高正常范围的老年受试者中已有描述。然而,痛风患者的认知功能是否比无症状高尿酸血症患者更差仍不清楚。本研究旨在评估老年男性痛风患者的认知功能,并进一步研究认知功能风险的遗传因素。本研究通过简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评估了205例男性痛风患者和204例对照者的认知功能。通过对102例男性痛风患者的全基因组关联研究(GWAS)数据评估这些认知指标的遗传基础。此外,在1179例男性痛风患者和1848例健康男性对照者中研究了GWAS中与认知相关的7个基因座与痛风的相关性。与对照组相比,痛风患者的MoCA评分显著更低[22.78±3.01 vs 23.42±2.95,P = 0.023,经年龄、体重指数(BMI)、教育程度和情绪障碍校正]。GWAS显示7个单核苷酸多态性(SNP)与MoCA测试存在常规全基因组显著性水平的关联(P < 9.6×10)。在14q22的KTN1基因内,rs12895072与rs12434554之间观察到最显著的关联(校正后P = 4.2×10,校正后P = 4.7×10)。第二显著信号位于7q22的RELN基因(rs155333,校正后P = 1.3×10),而rs17458357(校正后P = 3.98×10)、rs2572683(校正后P = 8.9×10)、rs12555895(校正后P = 2.6×10)和rs3764030(校正后P = 9.4×10)处的其他变异也具有统计学显著性。在进一步分析中,这7个SNP与痛风均无关联(所有P > 0.05)。患有痛风的老年男性受试者认知能力下降加速。在我们的中国老年男性痛风人群中,确定了几个神经退行性疾病风险基因座为认知能力的遗传因素。建议对痛风患者的认知能力和遗传分析进行更大规模的前瞻性研究。