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Wang J, Huang Y, Bei C, Yang H, Lin Z, Xu L. Causal associations of antioxidants with Alzheimer's disease and cognitive function: a Mendelian randomisation study. J Epidemiol Community Health 2024; 78:424-430. [PMID: 38589220 DOI: 10.1136/jech-2023-221184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/09/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Circulating antioxidants are associated with a lower risk of Alzheimer's disease (AD) in observational studies, suggesting potential target areas for intervention. However, whether the associations are causal remains unclear. Here, we studied the causality between antioxidants and AD or cognitive function using two-sample Mendelian randomisation (MR). METHODS Single nucleotide polymorphisms strongly (p<5×10-8) associated with antioxidants (vitamin A, vitamin C, zinc, selenium, β-carotene and urate) and outcomes (AD, cognitive performance and reaction time) were obtained from the largest and most recent genome-wide association studies (GWAS). MR inverse variance weighting (IVW) and MR pleiotropy residual sum and outlier test (MR-PRESSO) were used for data analysis. RESULTS Higher genetically determined selenium level was associated with 5% higher risk of AD (OR 1.047, 95% CI 1.005 to 1.091, p=0.028) using IVW. Higher genetically determined urate level was associated with worse cognitive performance (β=-0.026, 95% CI -0.044 to -0.008, p=0.005) using MR-PRESSO. No association between the other antioxidants and AD, cognitive performance and reaction time was found. Similar results were found in the sensitivity analyses. CONCLUSION Our results suggest that lifelong exposure to higher selenium may be associated with a higher risk of AD, and higher urate levels could be associated with worse cognitive performance. Further analyses using larger GWAS of antioxidants are warranted to confirm these observations. Our results suggest that caution is needed in the interpretation of traditional observational evidence on the neuroprotective effects of antioxidants.
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Affiliation(s)
- Jiao Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yingyue Huang
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Chunhua Bei
- School of Public Health, Guilin Medical University, Guilin, Guangxi, China
| | - Huiling Yang
- Eastern-fusion Master Studio of Hezhou, Hezhou, China
| | - Zihong Lin
- Hezhou Research Institute of Longevity Health Science, Hezhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
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Topiwala A, Mankia K, Bell S, Webb A, Ebmeier KP, Howard I, Wang C, Alfaro-Almagro F, Miller K, Burgess S, Smith S, Nichols TE. Association of gout with brain reserve and vulnerability to neurodegenerative disease. Nat Commun 2023; 14:2844. [PMID: 37202397 PMCID: PMC10195870 DOI: 10.1038/s41467-023-38602-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/09/2023] [Indexed: 05/20/2023] Open
Abstract
Studies of neurodegenerative disease risk in gout are contradictory. Relationships with neuroimaging markers of brain structure, which may offer insights, are uncertain. Here we investigated associations between gout, brain structure, and neurodegenerative disease incidence. Gout patients had smaller global and regional brain volumes and markers of higher brain iron, using both observational and genetic approaches. Participants with gout also had higher incidence of all-cause dementia, Parkinson's disease, and probable essential tremor. Risks were strongly time dependent, whereby associations with incident dementia were highest in the first 3 years after gout diagnosis. These findings suggest gout is causally related to several measures of brain structure. Lower brain reserve amongst gout patients may explain their higher vulnerability to multiple neurodegenerative diseases. Motor and cognitive impairments may affect gout patients, particularly in early years after diagnosis.
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Affiliation(s)
- Anya Topiwala
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
| | - Kulveer Mankia
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - Steven Bell
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Alastair Webb
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Isobel Howard
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Chaoyue Wang
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Shanghai, China
| | - Fidel Alfaro-Almagro
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Karla Miller
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Stephen Smith
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas E Nichols
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Longitudinal follow-up study of the association with gout and Alzheimer's disease and Parkinson's disease in Korea. Sci Rep 2023; 13:3696. [PMID: 36878976 PMCID: PMC9988850 DOI: 10.1038/s41598-023-30379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
To date, no clear conclusion on the relationships of gout with the occurrence of typical neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD), has been reached. This study aimed to determine whether the patients with gout are at a lower or higher probability of developing AD or PD than those without gout. Longitudinal follow-up data of a representative sample of Korean adults were assessed. 18,079 individuals diagnosed with gout between 2003 and 2015 were enrolled in the gout group. The comparison group comprised 72,316 demographics-matched individuals not diagnosed with gout. Longitudinal associations of gout with AD or PD were estimated using Cox proportional hazard regression adjusting for potential confounders. The adjusted hazard ratios (HRs) of AD and PD in the gout group were 1.01 and 1.16 times higher than controls, but these differences were not statistically significant (95% confidence interval [CI] = 0.92-1.12 and 95% CI = 0.97-1.38, respectively). Although there was no significant association in the entire sample, AD and PD probabilities in patients with gout were significantly higher in participants < 60 years, and PD probabilities in patients with gout were significantly higher in overweight participants. Our findings identify significant correlations of gout with AD and PD in participants < 60 years and gout with PD in those with overweight, indicating that gout may play a role in the development of neurodegenerative diseases in younger or overweight populations. Further investigations should be performed to corroborate these findings.
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Duque KR, Vizcarra JA, Hill EJ, Espay AJ. Disease-modifying vs symptomatic treatments: Splitting over lumping. HANDBOOK OF CLINICAL NEUROLOGY 2023; 193:187-209. [PMID: 36803811 DOI: 10.1016/b978-0-323-85555-6.00020-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Clinical trials of putative disease-modifying therapies in neurodegeneration have obeyed the century-old principle of convergence, or lumping, whereby any feature of a clinicopathologic disease entity is considered relevant to most of those affected. While this convergent approach has resulted in important successes in trials of symptomatic therapies, largely aimed at correcting common neurotransmitter deficiencies (e.g., cholinergic deficiency in Alzheimer's disease or dopaminergic deficiency in Parkinson's disease), it has been consistently futile in trials of neuroprotective or disease-modifying interventions. As individuals affected by the same neurodegenerative disorder do not share the same biological drivers, splitting such disease into small molecular/biological subtypes, to match people to therapies most likely to benefit them, is vital in the pursuit of disease modification. We here discuss three paths toward the splitting needed for future successes in precision medicine: (1) encourage the development of aging cohorts agnostic to phenotype in order to enact a biology-to-phenotype direction of biomarker development and validate divergence biomarkers (present in some, absent in most); (2) demand bioassay-based recruitment of subjects into disease-modifying trials of putative neuroprotective interventions in order to match the right therapies to the right recipients; and (3) evaluate promising epidemiologic leads of presumed pathogenetic potential using Mendelian randomization studies before designing the corresponding clinical trials. The reconfiguration of disease-modifying efforts for patients with neurodegenerative disorders will require a paradigm shift from lumping to splitting and from proteinopathy to proteinopenia.
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Affiliation(s)
- Kevin R Duque
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States
| | - Joaquin A Vizcarra
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Emily J Hill
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States.
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Lin Y, Hu T, Cheng L, Chen Y, Li W, Guo Q, Miao Y. Causal Effects of Plasma Haptoglobin Levels on Alzheimer's Disease: A Two-Sample Mendelian Randomization Study. J Alzheimers Dis 2023; 95:339-348. [PMID: 37522206 DOI: 10.3233/jad-230159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND A connection between plasma levels of haptoglobin (Hp) and Alzheimer's disease (AD) has been shown in several observational studies. It is debatable, nonetheless, how the two are related causally. OBJECTIVE To establish the causal relationship between Hp and AD using a two-sample Mendelian randomization (MR) study. METHODS From the extensive genome-wide association studies and FinnGen dataset, summaries and statistics pertaining to AD were gathered. We investigated the possibility of a causal link between Hp and AD using a two-sample MR study. Inverse variance weighting was used as the primary analytical technique, and it was supported by the joint application of complementary analyses and fixed effects meta-analysis to combine results from various sources. RESULTS Genetically determined Hp was causally associated with AD [odds ratio (OR), 1.05; 95% confidence interval (CI), 1.02 to 1.09; p = 8.96×10-4]; Inverse variance-weighted estimates coming from different data sources were combined in a meta-analysis with consistent findings (OR, 1.03; 95% CI, 1.01 to 1.05; p = 2.00×10-3). The outcomes of the inverse MR analysis showed that AD had no appreciable causal impact on Hp. CONCLUSION The present MR analysis shows that higher plasma Hp leads to an increased risk of AD. Strategies for plasma Hp testing may open up new doors for the early diagnosis and prevention of AD.
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Affiliation(s)
- Yijia Lin
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingjun Hu
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lizhen Cheng
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Chen
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qihao Guo
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya Miao
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Geng R, Zhang Y, Liu M, Deng S, Ding J, Zhong H, Tu Q. Elevated serum uric acid is associated with cognitive improvement in older American adults: A large, population-based-analysis of the NHANES database. Front Aging Neurosci 2022; 14:1024415. [PMID: 36570535 PMCID: PMC9772611 DOI: 10.3389/fnagi.2022.1024415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background The many studies revealing a connection between serum uric acid (SUA) and dementia have reported conflicting results. This study sought to investigate the relations between SUA and cognitive function in older adults. Materials and methods The sample was 2,767 American adults aged ≥60 years from the National Health and Nutrition Examination Survey 2011-2014. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer's Disease test, animal fluency test, digit symbol substitution test, and composite z-score. Multivariate linear regression analyses were conducted to estimate the association between SUA and cognitive function. Results SUA level and cognitive function were significantly, positively correlated. Age significantly correlated with the association between SUA and cognitive function. Conclusion These findings support a connection between SUA and cognition, showing a positive link between SUA and cognitive scores among older American adults. We contend that a slight rise in uric acid within the normal range is advantageous for enhanced cognition. To confirm the precise dose-time-response relation, more tests will be needed.
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Ou YN, Zhao B, Fu Y, Sheng ZH, Gao PY, Tan L, Yu JT. The Association of Serum Uric Acid Level, Gout, and Alzheimer's Disease: A Bidirectional Mendelian Randomization Study. J Alzheimers Dis 2022; 89:1063-1073. [PMID: 35964198 DOI: 10.3233/jad-220649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between serum uric acid (UA) and Alzheimer's disease (AD) risk still remained ambiguous despite extensive attempts. OBJECTIVE Via the two-sample Mendelian randomization (MR) design, we aimed to examine the bidirectional causal relationships of serum UA, gout, and the risk of AD. METHODS Genetic variants of UA, gout, and AD were extracted from published genome-wide association summary statistics. The inverse-variance weighted (IVW, the primary method), and several sensitivity methods (MR-Egger, weighted median, and weighted mode) were used to calculate the effect estimates. Egger regression, MR-PRESSO and leave-one-SNP-out analysis were performed to identify potential violations. RESULTS Genetic proxies for serum UA concentration [odds ratio (ORIVW) = 1.09, 95% confidence interval (CI) = 1.01-1.19, p = 0.031] were related with an increased risk of AD using 25 single nucleotide polymorphisms (SNPs). This causal effect was confirmed by sensitivity analyses including MR-Egger (1.22, 1.06-1.42, p = 0.014), weighted median (1.18, 1.05-1.33, p = 0.006), and weighted mode (1.20, 1.07-1.35, p = 0.005) methods. No evidence of notable directional pleiotropy and heterogeneity were identified (p > 0.05). Three SNPs (rs2078267, rs2231142, and rs11722228) significantly drove the observed causal effects. Supportive causal effect of genetically determined gout on AD risk was demonstrated using two SNPs (ORIVW = 1.05, 95% CI = 1.00-1.11, p = 0.057). No reverse causal effects of AD on serum UA levels and gout risk were found. CONCLUSION The findings revealed a causal relationship between elevated serum UA level and AD risk. However, further research is still warranted to investigate whether serum UA could be a reliable biomarker and therapeutic target for AD.
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Affiliation(s)
- Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Bing Zhao
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ze-Hu Sheng
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Pei-Yang Gao
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
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Abstract
PURPOSE OF REVIEW This review aims to summarize recent evidence regarding the complex relationship between uric acid (UA), gout, and brain diseases. RECENT FINDINGS Observational studies have suggested that patients with hyperuricemia or gout might have a decreased risk of neurodegenerative diseases. Conversely, they may be at increased risk of cerebrovascular disease. Mendelian randomization (MR) studies use a genetic score as an instrumental variable to address the causality of the association between a risk factor (here, UA or gout) and an outcome. So far, MR analyses do not support a causal relationship of UA or gout with Alzheimer's disease and dementia, and of UA with Parkinson's disease or stroke. Observation studies indicate a U-shaped association between UA and brain diseases, but MR studies do not support that this association is causal. Further studies should address the causal role of gout as well as the impact of urate-lowering therapy on these outcomes.
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The Influence of Serum Uric Acid Level on Alzheimer's Disease: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5525710. [PMID: 34124244 PMCID: PMC8192189 DOI: 10.1155/2021/5525710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022]
Abstract
As a powerful antioxidant in the human body, uric acid (UA) has been the subject of increasing research that focused on its influence on Alzheimer's disease (AD) in recent years. The latest literature was gathered to describe the influence of serum uric acid (SUA) level on the onset and progression of AD and to analyze the possibility that SUA is a biomarker of Alzheimer's disease. A large number of existing studies suggested that the SUA level was lower or tended to decrease in patients with AD, and increased SUA level may have a protective effect in AD, which could reduce the risk of onset and slowing the course of the disease. However, some Mendelian randomization analyses suggested that genetically determined uric acid was not associated with AD risk. Existing research results are contradictory due to the high inconsistency of the studies, the selection of subjects, and other factors. UA also showed a strong association with cognitive function, and there appeared to be a gender-selective neuroprotective action. Due to its potent antioxidant properties, the low uric acid level may contribute to oxidative stress to accelerate disease progression. But some preclinical data showed a possibility that in some special cases, UA had a prooxidant properties. The possibility was raised in the discussion of the underlying mechanism that both the low uric acid level and the rapidly progressive course of the disease were the consequence of malnutrition. This paper reviews recent advances in the study of SUA and AD which offers the possibility of new biomarker, new prevention, and treatment strategies for Alzheimer's disease.
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Genetically predicted serum urate levels have no causal role on depression or other psychiatric disorders. Clin Rheumatol 2021; 40:3729-3733. [PMID: 33786690 DOI: 10.1007/s10067-021-05718-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 12/19/2022]
Abstract
Clinicians are advised caution in reducing serum urate for gout management due to observational associations with risk of neuropsychiatric diseases. We examined the causal effect of genetically predicted serum urate levels on the risk of major depressive disorder (MDD), anxiety, and related psychiatric disorders using two-sample Mendelian randomization (MR). We identified single-nucleotide polymorphisms (SNPs) associated with serum urate from a genome-wide association study (GWAS) of 110,347 European-descent individuals. The causal effect of serum urate on MDD was tested using summary data from a GWAS of 135,458 cases and 344,901 controls of European descent. MR was performed using random-effects inverse variance-weighted method and a series of sensitivity analyses. This approach was repeated using summary GWAS data for anxiety, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, schizophrenia, and anorexia nervosa. We identified 30 SNPs associated with serum urate. Genetically predicted urate levels were not causally associated with risk of MDD (OR 0.98; 95% CI 0.94, 1.03), anxiety (OR 0.90; 95% CI 0.80, 1.02), or the other psychiatric conditions (OR range 0.95 to 1.06). Results were similar in sensitivity analyses. We found no evidence that genetically predicted serum urate has a causal effect on risk of MDD, anxiety, or other psychiatric disorders. Key Points • Clinicians are advised to be cautious about reducing the serum urate level too far in gout management, citing observational associations between low serum urate levels and various neuropsychiatric diseases. • In this two-sample Mendelian randomization study, we found no evidence for a causal link between genetically predicted serum urate level and the development of major depressive, anxiety, or other related psychiatric disorders. • Future revisions of clinical guidelines may need to reconsider recommendations regarding lower limits for serum urate levels.
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Preyer O, Concin H, Nagel G, Zitt E, Ulmer H, Brozek W. Serum uric acid is associated with incident hip fractures in women and men - Results from a large Austrian population-based cohort study. Maturitas 2021; 148:46-53. [PMID: 33836935 DOI: 10.1016/j.maturitas.2021.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/22/2021] [Accepted: 03/03/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Serum markers that can be used to estimate the risk of bone fractures are rare, and findings for one candidate marker, uric acid, are heterogeneous. Our aim was to investigate the potential of serum uric acid (SUA) to predict hip fractures occurring in people aged 50 years and over. STUDY DESIGN During a medical prevention program over the period 1985-2005 in Vorarlberg, baseline data were collected on SUA levels and covariates (age, BMI, blood pressure, smoking status, diabetes, triglycerides and cholesterol) from 185,397 individuals, of whom 42,488 women and 35,908 men met the inclusion criteria of this population-based cohort study. Information on incident cancer and end-stage kidney disease was acquired from registries. MAIN OUTCOME MEASURE Incident hip fracture occurring in participants aged 50 years and over during the observation period 2003-2013. RESULTS SUA was associated with a rise in female hip fracture risk by 6% per unit increase (HR 1.06, 95 %-CI 1.01-1.10), and risk in the highest vs. lowest SUA quartile was significantly increased (HR 1.17, 95 %-CI 1.01-1.35), but not at hyperuricemic (>5.7 mg/dl) vs. normouricemic (≤5.7 mg/dl) levels. In men, hip fracture risk rose by 15 % per unit increase (HR 1.15, 95 %-CI 1.08-1.22), and risk was significantly higher in the highest vs. lowest SUA quartile (HR 1.50, 95 %-CI 1.17-1.91) as well as at hyperuricemic (>7.0 mg/dl) vs. normouricemic (≤7.0 mg/dl) levels (HR 1.48, 95 %-CI 1.19-1.84). CONCLUSIONS Our results link SUA with increased risk of hip fractures, particularly in men.
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Affiliation(s)
- Oliver Preyer
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Hanno Ulmer
- Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria.
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Richard EL, McEvoy LK, Oren E, Alcaraz JE, Laughlin GA, LaCroix AZ, Salem RM. Markers of Kidney Function and Longitudinal Cognitive Ability Among Older Community-Dwelling Adults: The Rancho Bernardo Study. J Alzheimers Dis 2021; 83:319-331. [PMID: 34334390 PMCID: PMC8555353 DOI: 10.3233/jad-201605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reduced kidney function has been associated with cognitive decline. Most studies have examined a single marker of kidney function and have limited duration of follow-up. OBJECTIVE This study evaluated associations between markers of kidney function (urine albumin, estimated glomerular filtration rate [eGFR], and hyperuricemia) with cognitive performance over time. METHODS This is a longitudinal study of 1,634 community-dwelling adults (mean age = 71.7 years), with kidney function markers and cognitive ability measured at baseline (1992-1996) and at up to five additional time points with a maximum of 23.4 years (mean = 8.1 years) of follow-up. Associations between kidney function and cognitive performance were assessed using linear mixed effects models. Testing for interaction by sex was conducted. RESULTS Albuminuria (urine albumin-to-creatinine ratio [ACR]≥30 mg/g) was associated with steeper annual declines in global cognitive function (MMSE, β= -0.12, p = 0.003), executive function (Trails B, β= 4.50, p < 0.0001) and episodic memory (Buschke total recall, β= -0.62, p = 0.02) scores in men. Results were similar when cognitive test scores were regressed on latent trajectory classes of ACR. In men, hyperuricemia (serum uric acid [SUA]≥6.8 mg/dl for men and SUA≥6.0 mg/dl for women) was associated with lower baseline MMSE (β= -0.70, p = 0.009) scores but not with MMSE change over time. No such associations were detected in women. There were no significant associations between eGFR and cognitive performance for either sex. CONCLUSION In older men, albuminuria is an independent predictor of subsequent cognitive decline. More investigations are needed to explain the observed sex differences and the potential relationship between hyperuricemia and poorer global cognition.
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Affiliation(s)
- Erin L Richard
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Eyal Oren
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - John E Alcaraz
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Gail A Laughlin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Rany M Salem
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Luo Q, Wen Z, Li Y, Chen Z, Long X, Bai Y, Huang S, Yan Y, Lin R, Mo Z. Assessment Causality in Associations Between Serum Uric Acid and Risk of Schizophrenia: A Two-Sample Bidirectional Mendelian Randomization Study. Clin Epidemiol 2020; 12:223-233. [PMID: 32161502 PMCID: PMC7049772 DOI: 10.2147/clep.s236885] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Although increasing lines of evidence showed associations between serum uric acid (UA) levels and schizophrenia, the causality and the direction of the associations remain uncertain. Thus, we aimed to assess whether the relationships between serum UA levels and schizophrenia are causal and to determine the direction of the association. Patients and Methods Two-sample bidirectional Mendelian randomization (MR) analyses and various sensitivity analyses were performed utilizing the summary data from genome-wide association studies within the Global Urate Genetics Consortium and the Psychiatric Genomics Consortium. Secondary MR analyses in both directions were conducted within summary data using genetic risk scores (GRSs) as instrumental variables. Results Three MR methods provided no causal relationship between serum UA and schizophrenia. Furthermore, GRS approach showed similar results in the three MR methods after adjustment for heterogeneity. By contrast, inverse variance weighted method, weighted median and GRS approach suggested a causal effect of schizophrenia risk on serum UA after adjustment for heterogeneity (per 10-symmetric percentage increase in schizophrenia risk, beta: -0.039, standard error (SE): 0.013, P = 0.003; beta: -0.036, SE: 0.018, P = 0.043; beta: -0.039, SE: 0.013, P = 0.002; respectively). Moreover, in both directions' analyses, the heterogeneity and sensitivity tests suggested no strong evidence of bias due to pleiotropy. Conclusion Schizophrenia may causally affect serum UA levels, whereas the causal role of serum UA concentrations in schizophrenia was not supported by our MR analyses. These findings suggest that UA may be a useful potential biomarker for monitoring treatment or diagnosis of schizophrenia rather than a therapeutic target for schizophrenia.
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Affiliation(s)
- Qianqian Luo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zheng Wen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Yuanfan Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zefeng Chen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Xinyang Long
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Yulan Bai
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Shengzhu Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China
| | - Yunkun Yan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China
| | - Rui Lin
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
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14
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Liu H, Reynolds GP, Wei X. Uric Acid and High-Density Lipoprotein Cholesterol Are Differently Associated with Alzheimer’s Disease and Vascular Dementia. J Alzheimers Dis 2020; 73:1125-1131. [PMID: 31884488 DOI: 10.3233/jad-191111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hanxiang Liu
- Department of Neurology, Puer People’s Hospital, Puer, Yunnan, China
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Gavin P. Reynolds
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Xianwen Wei
- Department of Neurology, Puer People’s Hospital, Puer, Yunnan, China
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15
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Chang B, Guan H, Zhu W, Li S. Low Uric Acid Indicates Risk of Incidence of Trigeminal Neuralgia. J Craniofac Surg 2019; 30:e556-e558. [PMID: 30939556 DOI: 10.1097/scs.0000000000005497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Trigeminal neuralgia (TN) is a common cranial nerve disease. Uric acid (URIC), a water-soluble antioxidant discovered in human body, has been recognized in numerous recent studies to exert a crucial part in neuroprotection; however, the influence of URIC on TN remains unclear so far. This study aimed to examine the association of URIC with TN. METHODS From January 2017 to September 2018, medical records from the newly diagnosed patients with TN at the Xinhua Hospital were retrospectively recruited and analyzed. The serum URIC, creatinine, blood urea nitrogen, and albumin levels between TN patients and normal subjects were compared through the nonparametric tests. Moreover, the relationship of URIC levels with TN was assessed using the multiple linear regression models. RESULTS Compared with normal subjects (325.7 ± 74.3 μmol/L), URIC contents were remarkably decreased in TN patients (270.2 ± 75.9 μmol/L) (P < 0.05). Besides, URIC was regarded as a protective factor of TN, as verified by multivariate logistic regression models (odds ratio = 0.2, 95% confidence interval = 0.0-0.6; P < 0.05). CONCLUSION Low URIC content is associated with the risk of incidence of TN, and appropriately increasing the URIC level may prevent TN.
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Affiliation(s)
- Bowen Chang
- Department of Neurosurgery, XinHua Hospital, School of Medicine, Shanghai Jiaotong University
| | - Haochen Guan
- Department of Nephrology, HuaDong Hospital, School of Medicine, Fudan University, Shanghai, China
| | - Wanchun Zhu
- Department of Neurosurgery, XinHua Hospital, School of Medicine, Shanghai Jiaotong University
| | - Shiting Li
- Department of Neurosurgery, XinHua Hospital, School of Medicine, Shanghai Jiaotong University
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