Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China.
School of Medicine, Southeast University, Nanjing, PR China.
J Alzheimers Dis. 2019;69(1):135-144. doi: 10.3233/JAD-181126.
Serum uric acid (SUA) is a natural antioxidant that may exert neuroprotective effects against neurodegenerative diseases. The relationship between uric acid and cognitive functions has been extensively studied, but results remain conflicting.
To investigate potential associations between SUA level and mild cognitive impairment (MCI), and different domains of cognitive performances in patients with type 2 diabetes mellitus (T2DM).
A total of 352 T2DM subjects (208 males and 144 females) were enrolled. SUA level was determined by using the uricase method. Cognitive performances were assessed using a validated neuropsychological test battery. Generalized additive models and binary logistic regression analysis were fitted to determine the association between SUA and cognitive functions.
A total of 157 T2DM patients had MCI, and 195 displayed normal cognition. Compared with the controls, MCI patients exhibited lower SUA level (p = 0.009). Generalized additive models revealed a U-shaped curve relationship among SUA with Montreal Cognitive Assessment, Auditory Verbal Learning Test-immediate recall and Trail Making Test-B scores (all p < 0.05). Further logistic regression analysis showed a significant trend toward decreased MCI risk with increased SUA level among the subjects whose SUA level was below the cut-point (388.63 μmol/L); each unit increment in SUA level reduced the MCI risk by 0.7% (p = 0.003).
A U-shaped association between SUA level and global cognitive function, especially executive and memory function, existed in T2DM patients. Our findings will provide additional suggestions that an increase of SUA to a certain level may be a novel method to reduce the burden of T2DM-associated cognitive impairment.
血清尿酸（SUA）是一种天然抗氧化剂，可能对神经退行性疾病具有神经保护作用。尿酸与认知功能之间的关系已经得到了广泛的研究，但结果仍存在争议。
探讨 2 型糖尿病（T2DM）患者血清尿酸（SUA）水平与轻度认知障碍（MCI）及不同认知领域表现之间的潜在关系。
共纳入 352 例 T2DM 患者（男 208 例，女 144 例）。采用尿酸酶法测定 SUA 水平。采用经过验证的神经心理学测试组合评估认知功能。拟合广义加性模型和二项逻辑回归分析，以确定 SUA 与认知功能之间的关系。
共有 157 例 T2DM 患者患有 MCI，195 例患者认知正常。与对照组相比，MCI 患者的 SUA 水平较低（p = 0.009）。广义加性模型显示，SUA 与蒙特利尔认知评估、听觉词语学习测试即刻回忆和连线测试 B 部分得分之间呈 U 型曲线关系（均 p < 0.05）。进一步的逻辑回归分析显示，在 SUA 水平低于切点（388.63 μmol/L）的患者中，SUA 水平升高与 MCI 风险降低呈显著趋势；SUA 水平每增加 1 个单位，MCI 风险降低 0.7%（p = 0.003）。
在 T2DM 患者中，SUA 水平与整体认知功能，尤其是执行功能和记忆功能之间存在 U 型关系。我们的研究结果提供了额外的证据，即增加 SUA 至一定水平可能是降低 T2DM 相关认知障碍负担的一种新方法。
