Zhou Xiangjun, Wang Zhe, Zhu Yi, Feng Shuang, Wu Haijian, Zhu Dongliang, Wu Zheyuan, Kao Qingjun
Hangzhou Center for Disease Control and Prevention (Hangzhou Health Supervision Institution), Hangzhou, P. R. China.
J Alzheimers Dis. 2025 Jan;103(2):582-592. doi: 10.1177/13872877241303789. Epub 2025 Jan 10.
Serum uric acid (SUA) was a predictor of cognitive function. The association of SUA/serum creatinine ratio (Scr), which represents renal function-normalized SUA and cognitive function is unknown.
This study investigated the association of the SUA/Scr with cognitive function and the potential mediation effect of inflammation in the above relationship.
This study used 1-5 waves of data from the China Health and Retirement Longitudinal Study. 3302 participants aged 45-60 years at baseline were included. Among them, 1129 who attended subsequent 2-3 waves were further included for cumulative exposure calculation to the SUA/Scr ratio. The Cox models were used to evaluate the impact of baseline SUA/Scr ratio and its cumulative exposure on cognitive function decline.
During a median follow-up of 8.6 years, there were 1512 (45.8%) cognitive function declined. After adjustment, the highest quartile of the SUA/SCr ratio was associated with the highest risk of cognitive function decline (Hazard ratio, 1.175; 95% confidence interval, 1.015-1.360). Restricted cubic spline showed a linear association between the SUA/Scr ratio and the risk of cognitive function decline (p= 0.514). There were a stronger association of cumulative SUA/Scr ratio and its exposure burden with cognitive function decline [the highest versus lowest quartile: 1.635 (1.006-2.656), the high versus low group: 1.729 (1.212-2.466), respectively]. No significant mediating effect through white blood cell count or C-reactive protein in SUA/Scr ratio-cognitive function decline was found.
The SUA/Scr ratio was associated with a higher risk of cognitive decline, whereas the mechanism mediated by inflammation indicators was not found.
血清尿酸（SUA）是认知功能的一个预测指标。代表肾功能正常化SUA的SUA/血清肌酐比值（Scr）与认知功能之间的关联尚不清楚。
本研究调查了SUA/Scr与认知功能之间的关联以及炎症在上述关系中的潜在中介作用。
本研究使用了中国健康与养老追踪调查1至5轮的数据。纳入了3302名基线年龄在45至60岁的参与者。其中，1129名参加了后续第2至3轮调查的参与者被进一步纳入，用于计算SUA/Scr比值的累积暴露量。采用Cox模型评估基线SUA/Scr比值及其累积暴露对认知功能下降的影响。
在中位随访8.6年期间，有1512名（45.8%）参与者认知功能下降。调整后，SUA/SCr比值的最高四分位数与认知功能下降的最高风险相关（风险比，1.175；95%置信区间，1.015 - 1.360）。限制立方样条显示SUA/Scr比值与认知功能下降风险之间存在线性关联（p = 0.514）。累积SUA/Scr比值及其暴露负担与认知功能下降之间的关联更强[最高四分位数与最低四分位数相比：1.635（1.006 - 2.656），高暴露组与低暴露组相比：1.729（1.212 - 2.466）]。未发现通过白细胞计数或C反应蛋白在SUA/Scr比值 - 认知功能下降关系中有显著的中介作用。
SUA/Scr比值与较高的认知下降风险相关，而未发现炎症指标介导的机制。
