Department of Neurology, The First Hospital of Jilin University, Chang Chun, China.
Department of Hepatology, Tianjin Medical University, Tianjin Second People's Hospital, Tianjin, China.
BMC Psychiatry. 2021 Jan 7;21(1):17. doi: 10.1186/s12888-020-03019-8.
High serum uric acid (SUA) levels may provide protection against depression and anxiety through its defensive role in oxidative damage. The aim of this study was to test the hypothesis of the independent associations of lower SUA levels with depressive and anxiety symptoms among patients with epilepsy (PWE).
A cross-sectional study was performed among 320 PWE aged ≥18 years old in Northeast China. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E; Chinese version) and the Generalized Anxiety Disorder-7 scale (GAD-7; Chinese version) were used as screening tools for depressive and anxiety symptoms for PWE. Serum uric acid levels were measured. The associations of SUA levels with depressive and anxiety symptoms were assessed by using binary logistic regression models, with adjustment for the related risk factors (P< 0.05).
Lower SUA tertiles were significantly associated with higher C-NDDI-E and GAD-7 scores compared with the higher two tertiles (p=0.001, and p= 0.002). Patients with depressive symptoms exhibited significantly lower SUA levels compared to those without depressive symptoms (p< 0.001). SUA levels of patients with anxiety symptoms were significantly lower than those of patients without anxiety symptoms (p< 0.001). The first and second SUA tertiles were associated with depressive symptoms, with the third tertile group as the reference group, after adjusting for confounders (first tertile: OR = 4.694, 95% CI = 1.643~ 13.413, P = 0.004; second tertile: OR = 3.440, 95% CI = 1.2789.256, P = 0.014). However, The first and second SUA tertiles were not associated with the risk of anxiety symptoms compared with the third tertile in the adjusted logistic regression model (First tertile: OR = 1.556, 95% CI = 0.6993.464, P = 0.279; second tertile: OR = 1.265, 95% CI = 0.607~2.635, P = 0.530).
We found that lower SUA levels were independently associated with depressive symptoms but not with anxiety symptoms among PWE. Further well-designed prospective cohort studies are required to determine the causality of the associations and to further clarify the mechanisms of SUA in depressive symptoms.
高血清尿酸（SUA）水平可能通过其在氧化损伤中的防御作用提供对抑郁和焦虑的保护。本研究旨在检验低 SUA 水平与癫痫患者（PWE）抑郁和焦虑症状之间独立关联的假设。
在中国东北地区进行了一项横断面研究，纳入了 320 名年龄≥18 岁的 PWE。使用神经障碍抑郁量表癫痫版（NDDI-E；中文版本）和广泛性焦虑症-7 量表（GAD-7；中文版本）作为 PWE 抑郁和焦虑症状的筛查工具。测量血清尿酸水平。采用二元逻辑回归模型评估 SUA 水平与抑郁和焦虑症状的关联，并对相关危险因素进行调整（P<0.05）。
与较高的两个 tertiles 相比，较低的 SUA tertiles 与较高的 C-NDDI-E 和 GAD-7 评分显著相关（p=0.001，p=0.002）。有抑郁症状的患者的 SUA 水平明显低于无抑郁症状的患者（p<0.001）。有焦虑症状的患者的 SUA 水平明显低于无焦虑症状的患者（p<0.001）。在调整混杂因素后，SUA 的第一和第二 tertiles 与抑郁症状相关，以第三 tertiles 为参考组（第一 tertiles：OR=4.694，95%CI=1.64313.413，P=0.004；第二 tertiles：OR=3.440，95%CI=1.2789.256，P=0.014）。然而，在调整后的逻辑回归模型中，SUA 的第一和第二 tertiles 与第三 tertiles 相比，与焦虑症状的风险无关联（第一 tertiles：OR=1.556，95%CI=0.6993.464，P=0.279；第二 tertiles：OR=1.265，95%CI=0.6072.635，P=0.530）。
我们发现，在 PWE 中，较低的 SUA 水平与抑郁症状独立相关，但与焦虑症状无关。需要进一步进行设计良好的前瞻性队列研究，以确定关联的因果关系，并进一步阐明 SUA 在抑郁症状中的作用机制。
