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Wu S, Pan D, Wang H, Guo J, Zhang F, Ning Y, Gu Y, Guo L. Establishment, Prediction, and Validation of a Nomogram for Cognitive Impairment in Elderly Patients With Diabetes. J Diabetes Res 2024; 2024:5583707. [PMID: 39188897 PMCID: PMC11347027 DOI: 10.1155/2024/5583707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/24/2024] [Accepted: 07/08/2024] [Indexed: 08/28/2024] Open
Abstract
Objective: The purpose of this study is to establish a predictive model of cognitive impairment in elderly people with diabetes. Methods: We analyzed a total of 878 elderly patients with diabetes who were part of the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The data were randomly divided into training and validation cohorts at a ratio of 6:4. The least absolute shrinkage and selection operator (LASSO) logistic regression analysis to identify independent risk factors and construct a prediction nomogram for cognitive impairment. The performance of the nomogram was assessed using receiver operating characteristic (ROC) curve and calibration curve. Decision curve analysis (DCA) was performed to evaluate the clinical utility of the nomogram. Results: LASSO logistic regression was used to screen eight variables, age, race, education, poverty income ratio (PIR), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum uric acid (SUA), and heart failure (HF). A nomogram model was built based on these predictors. The ROC analysis of our training set yielded an area under the curve (AUC) of 0.786, while the validation set showed an AUC of 0.777. The calibration curve demonstrated a good fit between the two groups. Furthermore, the DCA indicated that the model has a favorable net benefit when the risk threshold exceeds 0.2. Conclusion: The newly developed nomogram has proved to be an important tool for accurately predicting cognitive impairment in elderly patients with diabetes, providing important information for targeted prevention and intervention measures.
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Affiliation(s)
- Sensen Wu
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Dikang Pan
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Hui Wang
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Julong Guo
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Fan Zhang
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Yachan Ning
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Yongquan Gu
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
| | - Lianrui Guo
- Department of Vascular SurgeryXuanwu HospitalCapital Medical University, 45 Changchun Street, Xicheng District, Beijing, China
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Sekine M, Fujiwara M, Okamoto K, Ichida K, Nagata K, Hille R, Nishino T. Significance and amplification methods of the purine salvage pathway in human brain cells. J Biol Chem 2024; 300:107524. [PMID: 38960035 PMCID: PMC11342100 DOI: 10.1016/j.jbc.2024.107524] [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: 05/03/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024] Open
Abstract
Previous studies suggest that uric acid or reactive oxygen species, products of xanthine oxidoreductase (XOR), may associate with neurodegenerative diseases. However, neither relationship has ever been firmly established. Here, we analyzed human brain samples, obtained under protocols approved by research ethics committees, and found no expression of XOR and only low levels of uric acid in various regions of the brain. In the absence of XOR, hypoxanthine will be preserved and available for incorporation into the purine salvage pathway. To clarify the importance of salvage in the brain, we tested using human-induced pluripotent stem cell-derived neuronal cells. Stable isotope analyses showed that the purine salvage pathway was more effective for ATP synthesis than purine de novo synthesis. Blood uric acid levels were related to the intracellular adenylate pool (ATP + ADP + AMP), and reduced levels of this pool result in lower uric acid levels. XOR inhibitors are related to extracellular hypoxanthine levels available for uptake into the purine salvage pathway by inhibiting the oxidation of hypoxanthine to xanthine and uric acid in various organs where XOR is present and can prevent further decreases in the intracellular adenylate pool under stress. Furthermore, adding precursors of the pentose phosphate pathway enhanced hypoxanthine uptake, indicating that purine salvage is activated by phosphoribosyl pyrophosphate replenishment. These findings resolve previous contradictions regarding XOR products and provide new insights into clinical studies. It is suggested that therapeutic strategies maximizing maintenance of intracellular adenylate levels may effectively treat pathological conditions associated with ischemia and energy depletion.
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Affiliation(s)
- Mai Sekine
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo, Tokyo, Japan; Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan.
| | - Megumi Fujiwara
- Department of Laboratory of Morphological Analysis, Nippon Medical School, Bunkyo, Tokyo, Japan
| | - Ken Okamoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Kimiyoshi Ichida
- Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan
| | - Koji Nagata
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Russ Hille
- Department of Biochemistry, University of California, Riverside, California, USA
| | - Takeshi Nishino
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo, Tokyo, Japan; Professor Emeritus, Nippon Medical School, Bunkyo, Tokyo, Japan; University of Tokyo Health Sciences, Tama, Tokyo, Japan.
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3
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Ding M, Lang X, Wang J, Shangguan F, Zhang XY. Prevalence, demographic characteristics, and clinical features of suicide risk in first episode drug-naïve schizophrenia patients with comorbid severe anxiety. J Psychiatr Res 2024; 176:232-239. [PMID: 38889553 DOI: 10.1016/j.jpsychires.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 05/19/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Both anxiety symptoms and suicide risk are common in schizophrenia. However, previous findings about the association between anxiety and suicide risk in schizophrenia were controversial. This study is the first to examine the prevalence of suicide risk and related demographic, clinical features in a large sample of first episode drug-naïve (FEDN) schizophrenia patients with comorbid severe anxiety. METHODS In total, 316 patients with FEDN schizophrenia were enrolled in this study. Patients' symptoms were assessed using the Hamilton Depression Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS). Serum levels of glucose, insulin, uric acid, and lipids including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were evaluated. RESULTS In the current study, 56.3% patients presented comorbid severe anxiety. The rate of suicide risk was higher in the severe anxiety group (55.6%) than in the mild-moderate anxiety group (33.3%). The interactions among severe anxiety, uric acid and HDL-C were associated with suicide risk. Compared with patients with normal uric acid, those with abnormal uric acid exhibited a stronger association between HAMA scores and HAMD-suicide item scores. This enhanced association was also observed for patients with abnormal HDL-C levels. CONCLUSIONS In FEDN schizophrenia patients with comorbid severe anxiety, our findings suggested a high incidence of suicide risk. Abnormal levels of uric acid and low levels of HDL-C, as well as high depression may be associated with an increased risk of suicide in FEDN schizophrenia patients with comorbid severe anxiety.
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Affiliation(s)
- Mengjie Ding
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Xiaoe Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Shanxi, 030000, China.
| | - Junhan Wang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Fangfang Shangguan
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Jiang Z, Chen J, Wu S, Ji S, Yang Y, Fang W, Li Z, Lin J, Chen J, Wu C, Kwan HY, Lai Y, Zhao X. Serum Uric Acid Levels Associated with Outcomes of Neurodegenerative Disorders and Brain Health: Findings from the UK Biobank. J Nutr Health Aging 2024; 28:100319. [PMID: 39094296 DOI: 10.1016/j.jnha.2024.100319] [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: 05/28/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND The relationship between serum uric acid (SUA) levels and brain-related health remains uncertain. OBJECTIVES This study aimed to investigate the relationship between SUA levels and some neurodegenerative disorders and brain structure. DESIGN A longitudinal study. SETTING AND PARTICIPANTS 384,517 participants who did not have stroke, dementia, and Parkinsonism, with complete urate testes and covariates were included. MEASUREMENTS Cox proportional hazards models, competing risk models, and restricted cubic spine models were applied. RESULTS During the median follow-up time of 12.7 years (interquartile range [IQR]:12.0, 13.5), 7821 (2.0%) participants developed stroke, 5103 (1.3%) participants developed dementia, and 2341 (0.6%) participants developed Parkinsonism. Nonlinear relationships were identified between SUA levels and stroke (J-shaped), dementia, and Parkinsonism (U-shaped). SUA levels of 4.2 mg/dl, 6.4 mg/dl, and 6.6 mg/dl yielded the lowest risk of stroke, dementia, and Parkinsonism, respectively. Besides, we found high SUA levels reduced the volumes of total brain, grey matter, white matter, grey matter in the hippocampus, and hippocampus, but increased lateral-ventricle volume. Inflammation accounted for 9.1% and 10.0% in the association of SUA with stroke and lateral-ventricle volume. CONCLUSIONS Lower SUA levels increased the risk of Parkinsonism, while both lower and higher SUA levels were positively associated with increased risk of stroke and dementia. Moreover, high SUA levels reduced brain structure volumes. Our findings suggest the association between SUA levels and brain-related disorders and highlight the importance of SUA management.
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Affiliation(s)
- Zihao Jiang
- Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jieyu Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Siqi Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Shuai Ji
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Ying Yang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Wen Fang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Ziwei Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jingxin Lin
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jie Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Chuanghai Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Hiu Yee Kwan
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Yigui Lai
- People's Hospital of Yangjiang, Yangjiang 529500, China.
| | - Xiaoshan Zhao
- Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
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Alrouji M, Al-Kuraishy HM, Al-Gareeb AI, Alshammari MS, Alexiou A, Papadakis M, Bahaa MM, Batiha GES. Role of uric acid in neurodegenerative diseases, focusing on Alzheimer and Parkinson disease: A new perspective. Neuropsychopharmacol Rep 2024. [PMID: 39075837 DOI: 10.1002/npr2.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/19/2024] [Accepted: 04/07/2024] [Indexed: 07/31/2024] Open
Abstract
Neurodegenerative diseases (NDs) such as Alzheimer disease (AD) and Parkinson disease (PD) are group of diseases affecting the central nervous system (CNS) characterized by progressive neurodegenerations and cognitive impairment. Findings from different studies highlighted the beneficial and detrimental effects of serum uric acid on the development and progression of NDs. Therefore, this mini-review aims to discuss the beneficial and detrimental effects of uric on NDs. The neuroprotective effect of uric acid is mainly related to the antioxidant effect of uric acid which alleviates oxidative stress-induced neurodegeneration in AD and PD. However, long-term effect of hyperuricemia prompts for the development and progression of cognitive impairment. Hyperuricemia is associated with cognitive impairment and dementia, and gout increases dementia risk. In addition, hyperuricemia can cause cerebral vascular injury which is a risk factor for vascular dementia and cognitive impairment. Taken together, the relationship between uric acid and NDs risk remains conflicting. Hence, preclinical and clinical studies are indicated in this regard.
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Affiliation(s)
- Mohammed Alrouji
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Mohammed S Alshammari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh University, Mohali, Punjab, India
- Department of Research & Development, Funogen, Athens, Greece
- Department of Research & Development, AFNP Med, Wien, Austria
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
| | - Mostafa M Bahaa
- Faculty of Pharmacy, Pharmacy Practice Department, Horus University, New Damietta, Egypt
| | - Gaber El-Saber Batiha
- Faculty of Veterinary Medicine, Department of Pharmacology and Therapeutics, Damanhour University, Damanhour, Egypt
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6
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Chen G, Tong L, Ye Q. Association between the serum uric acid/serum creatinine ratio and cognitive function in older adults: NHANES in the United States. Sci Rep 2024; 14:16312. [PMID: 39009809 PMCID: PMC11251062 DOI: 10.1038/s41598-024-67580-y] [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: 02/22/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
Cognitive impairment can potentially become a significant health concern in older adults. However, early effective diagnostic methods are still lacking. Therefore, we utilized the NHANES database in the US to investigate the relationship between serum uric acid to serum creatinine (SUA/SCR) ratio and cognitive impairment. In our study, a total of 3874 participants were included (2001-2002, 2011-2014). Weighted t tests or chi-square tests were utilized to analyze the basic characteristics of the population. Weighted logistic regression analysis, smooth-fit curves, threshold effects, and subgroup analysis were conducted to investigate the correlation between the SUA/SCR and cognitive impairment. In this study, the SUA/SCR was significantly lower in individuals with cognitive impairment. The logistic regression model, after adjusting for all covariates, revealed that the Q2-Q4 were 0.65 (95% CI 0.49, 0.86), 0.60 (95% CI 0.40, 0.90), 0.55 (95% CI 0.39, 0.77) respectively. This indicates that participants in the Q4 had a 45% reduced risk of cognitive impairment. Smooth-fit curves and threshold effect analysis revealed a nonlinear relationship between SUA/SCR and cognitive impairment, with a turning point at 4.13. Subgroup analysis showed no statistically significant differences in the relationship between SUA/SCR and cognitive impairment among different subgroups (P > 0.05). Our findings indicate a negative correlation between the SUA/SCR and the risk of cognitive impairment in the population of adults aged 60 and above in the US. This suggests that the SUA/SCR holds promise as a potential indicator for cognitive impairment.
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Affiliation(s)
- Gang Chen
- Department of Laboratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - Ling Tong
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing Ye
- Department of Laboratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China.
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Eliseev MS, Zheliabina OV, Nasonov EL. [Uric acid, cognitive disorders, neurodegeneration]. TERAPEVT ARKH 2024; 96:447-452. [PMID: 38829804 DOI: 10.26442/00403660.2024.05.202698] [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: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 06/05/2024]
Abstract
This article examines the role of uric acid (UA) in cognitive changes and neurodegeneration, focusing on its functions as an antioxidant and prooxidant. Research suggests that changes in serum UA levels may be associated with the development or delay of cognitive impairment, especially in the context of neurodegenerative diseases such as Alzheimer's disease. It was revealed that there is a relationship between the level of UA and the dynamics of cognitive functions, indicating the potential neuroprotective properties of UA. Particular attention is paid to the balance between the antioxidant and prooxidant properties of UA, which may play a key role in protecting neurons from damage. However, research results are not clear-cut, highlighting the need for further research to more fully understand the role of UA in cognitive processes. Determining the optimal serum UA level may be an important step in developing strategies for the prevention and treatment of cognitive impairment associated with neurodegeneration. Overall, these studies advance the understanding of the mechanisms underlying the interaction between uric acid metabolism and brain health.
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Affiliation(s)
| | | | - E L Nasonov
- Nasonova Research Institute of Rheumatology
- Sechenov First Moscow State Medical University (Sechenov University)
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Xiao Q, Wang J, Tian Q, Tian N, Tian Q, He X, Wang Y, Dong Z. Uric Acid Mitigates Cognitive Deficits via TFEB-Mediated Microglial Autophagy in Mice Models of Alzheimer's Disease. Mol Neurobiol 2024; 61:3678-3696. [PMID: 38008888 DOI: 10.1007/s12035-023-03818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
Clinical trials have demonstrated the potential neuroprotective effects of uric acid (UA) in Alzheimer's disease (AD). However, the specific mechanism underlying the neuroprotective effect of UA remains unclear. In the present study, we investigated the neuroprotective effect and underlying mechanism of UA in AD mouse models. Various behavioral tests including an elevated plus maze, Barnes maze, and Morris water maze were conducted to evaluate the impact of UA on cognitive function in β-amyloid (Aβ) microinjection and APP23/PS45 double transgenic mice models of AD. Immunohistochemical staining was employed to visualize pathological changes in the brains of AD model mice. Western blotting and immunofluorescence techniques were used to assess levels of autophagy-related proteins and transcription factor EB (TFEB)-related signaling pathways. BV2 cells were used to investigate the association between UA and microglial autophagy. We reported that UA treatment significantly alleviated memory decline in Aβ-induced AD model mice and APP23/PS45 double transgenic AD model mice. Furthermore, UA activated microglia and upregulated the autophagy-related proteins such as LC3II/I ratio, Beclin-1, and LAMP1 in the hippocampus of AD model mice. Similarly, UA protected BV2 cells from Aβ toxicity by upregulating the expressions of Beclin-1, LAMP1, and the LC3II/I ratio, whereas genetic inhibition of TFEB completely abolished these protective effects. Our results indicate that UA may serve as a novel activator of TFEB to induce microglia autophagy and facilitate Aβ degradation, thereby improving cognitive function in AD model mice. Therefore, these findings suggest that UA may be a novel therapeutic agent for AD treatment.
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Affiliation(s)
- Qian Xiao
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaojiao Wang
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qiuyun Tian
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Na Tian
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Tian
- Department of Geratology, Chongqing Key Laboratory of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin He
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yutian Wang
- Brain Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Zhifang Dong
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
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9
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Koh S, Lee DY, Cha JM, Kim Y, Kim HH, Yang HJ, Park RW, Choi JY. Association between pre-diagnostic serum uric acid levels in patients with newly diagnosed epilepsy and conversion rate to drug-resistant epilepsy within 5 years: A common data model analysis. Seizure 2024; 118:103-109. [PMID: 38669746 DOI: 10.1016/j.seizure.2024.04.014] [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: 01/16/2024] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
PURPOSE Drug-resistant epilepsy (DRE) poses a significant challenge in epilepsy management, and reliable biomarkers for identifying patients at risk of DRE are lacking. This study aimed to investigate the association between serum uric acid (UA) levels and the conversion rate to DRE. METHODS A retrospective cohort study was conducted using a common data model database. The study included patients newly diagnosed with epilepsy, with prediagnostic serum UA levels within a six-month window. Patients were categorized into hyperUA (≥7.0 mg/dL), normoUA (<7.0 and >2.0 mg/dL), and hypoUA (≤2.0 mg/dL) groups based on their prediagnostic UA levels. The outcome was the conversion rate to DRE within five years of epilepsy diagnosis. RESULTS The study included 5,672 patients with epilepsy and overall conversion rate to DRE was 19.4%. The hyperUA group had a lower DRE conversion rate compared to the normoUA group (HR: 0.81 [95% CI: 0.69-0.96]), while the hypoUA group had a higher conversion rate (HR: 1.88 [95% CI: 1.38-2.55]). CONCLUSIONS Serum UA levels have the potential to serve as a biomarker for identifying patients at risk of DRE, indicating a potential avenue for novel therapeutic strategies aimed at preventing DRE conversion.
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Affiliation(s)
- Seungyon Koh
- Department of Brain Science, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Suwon 16499, Republic of Korea; Department of Biomedical Sciences, Graduate School of Ajou University, Suwon, Republic of Korea; Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Kore; Department of Medical Sciences, Graduate School of Ajou University, Suwon, Republic of Korea; Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae Myung Cha
- Department of Gastroenterology, Gang Dong Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hyung Hoi Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Kore.
| | - Jun Young Choi
- Department of Brain Science, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Suwon 16499, Republic of Korea; Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea.
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10
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Laudisio A, Dorizzi A, Villeggia F, Latino F, Filippucci D, Zuccalà G. Association of serum uric acid with functional disability in older subjects: a population-based study. Aging Clin Exp Res 2024; 36:96. [PMID: 38630352 PMCID: PMC11023951 DOI: 10.1007/s40520-024-02746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The role of serum uric acid (SUA) in the development of adverse health outcomes in advanced age is still uncertain. AIMS The aim of the study was to assess the association of disability with SUA levels in older community-dwelling subjects. METHODS We assessed the association of disability with SUA in all 351 inhabitants of Tuscania (Italy) aged 75+. Functional ability was estimated using the instrumental activities of daily living (IADLs). RESULTS In logistic regression, increasing SUA levels were associated with disability (OR = 1.22; 95%CI = 1.01-1.48; P = .036), after adjusting. The association was independent of both gender and age (P for interaction > 0.050). SUA levels above 5.5 mg/dL best predicted disability. CONCLUSIONS In older subjects, SUA levels are associated with disability; the cut off level above 5.5 mg/dL might be adopted in pharmacological trials aiming at reducing the incidence and progression of disability by reducing SUA, and for identifying subjects at increased risk of disability.
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Affiliation(s)
- Alice Laudisio
- Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, 21 - 00128, Italy.
- Operative Research Unit of Geriatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, 200 - 00128, Italy.
| | - Agnese Dorizzi
- Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, 21 - 00128, Italy
| | - Fabio Villeggia
- Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, 21 - 00128, Italy
| | - Francesca Latino
- Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, 21 - 00128, Italy
| | - Daniele Filippucci
- Department of Medicine, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, 21 - 00128, Italy
| | - Giuseppe Zuccalà
- Department of Geriatric and Orthopaedic Sciences, Catholic University of Medicine, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, Rome, 00168, Italy
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11
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Iazzolino B, Grassano M, Moglia C, Canosa A, Manera U, Vasta R, Cabras S, Callegaro S, Matteoni E, Di Pede F, Palumbo F, Mora G, Calvo A, Chiò A. High serum uric acid levels are protective against cognitive impairment in amyotrophic lateral sclerosis. J Neurol 2024; 271:955-961. [PMID: 37880536 PMCID: PMC10827906 DOI: 10.1007/s00415-023-12056-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Uric acid (UA) has emerged as a factor that can modify cognitive function both in the general population and in people with neurodegenerative disorders. Since very few data are available concerning amyotrophic lateral sclerosis (ALS), we explored the correlation of UA levels and cognitive impairment in a large cohort of ALS patients. METHODS We enrolled ALS patients consecutively seen at the Turin ALS expert center in the 2007-2018 period who underwent both cognitive/behavioral and UA evaluation at diagnosis. Patients were classified in 5 categories: normal cognition (ALS-CN), isolated cognitive impairment (ALSci), isolated behavioural impairment (ALSbi), cognitive and behavioural impairment (ALScbi), frontotemporal dementia (ALS-FTD). For this study, ALSci, ALSbi and ALScbi were merged as ALS with intermediate cognitive impairment (ALS-INT). RESULTS Out of the 841 ALS patients, 422 had ALS-CN, 271 ALS-INT and 148 ALS-FTD. The mean values of UA were significantly different among the cognitive subgroups of patients, with the lowest values in the ALS-FTD (ALS-CN, 288.5 ± 78.0 (μmol/L; ALS-INT, 289.7 ± 75.5 μmol/L; ALS-FTD, 271.8 ± 74.9 μmol/L; p = 0.046). The frequency of ALS-FTD was significantly higher in the 1st tertile of UA. Lower UA levels were independently associated with FTD (OR 1.32, 95% c.i. 1.01-1.43; p = 0.038) in binary logistic regression. CONCLUSIONS We found that in ALS lower UA serum levels are correlated with reduced frequency of co-morbid FTD. Patients with intermediate cognitive impairment showed UA levels similar to ALS-CN but higher than ALS-FTD, implying that higher UA levels can prevent or delay cognitive function deterioration.
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Affiliation(s)
- Barbara Iazzolino
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Maurizio Grassano
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Cristina Moglia
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
- Neurology I, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio Canosa
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
- Neurology I, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
- Institute of Cognitive Science and Technologies, National Research Council, Rome, Italy
| | - Umberto Manera
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
- Neurology I, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosario Vasta
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Sara Cabras
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
- International School of Advanced Studies, University of Camerino, Camerino, Italy
| | - Stefano Callegaro
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Enrico Matteoni
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Francesca Di Pede
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Francesca Palumbo
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Gabriele Mora
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Andrea Calvo
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy
- Neurology I, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Adriano Chiò
- Department of Neuroscience "Rita Levi Montalcini", ALS Center, University of Turin, Via Cherasco 15, 10126, Turin, Italy.
- Neurology I, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
- Institute of Cognitive Science and Technologies, National Research Council, Rome, Italy.
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Oliphant K, Cruz Ayala W, Ilyumzhinova R, Mbayiwa K, Sroka A, Xie B, Andrews B, Keenan K, Claud EC. Microbiome function and neurodevelopment in Black infants: vitamin B 12 emerges as a key factor. Gut Microbes 2024; 16:2298697. [PMID: 38303501 PMCID: PMC10841033 DOI: 10.1080/19490976.2023.2298697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024] Open
Abstract
The early life gut microbiome affects the developing brain, and therefore may serve as a target to support neurodevelopment of children living in stressful and under-resourced environments, such as Black youth living on the South Side of Chicago, for whom we observe racial disparities in health. Microbiome compositions/functions key to multiple neurodevelopmental facets have not been studied in Black children, a vulnerable population due to racial disparities in health; thus, a subsample of Black infants living in urban, low-income neighborhoods whose mothers participated in a prenatal nutrition study were recruited for testing associations between composition and function of the gut microbiome (16S rRNA gene sequencing, shotgun metagenomics, and targeted metabolomics of fecal samples) and neurodevelopment (developmental testing, maternal report of temperament, and observed stress regulation). Two microbiome community types, defined by high Lachnospiraceae or Enterobacteriaceae abundance, were discovered in this cohort from 16S rRNA gene sequencing analysis; the Enterobacteriaceae-dominant community type was significantly negatively associated with cognition and language scores, specifically in male children. Vitamin B12 biosynthesis emerged as a key microbiome function from shotgun metagenomics sequencing analysis, showing positive associations with all measured developmental skills (i.e., cognition, language, motor, surgency, effortful control, and observed stress regulation). Blautia spp. also were identified as substantial contributors of important microbiome functions, including vitamin B12 biosynthesis and related vitamin B12-dependent microbiome functions, anti-inflammatory microbial surface antigens, competitive mechanisms against pathobionts, and production of antioxidants. The results are promising with respect to the potential for exploring therapeutic candidates, such as vitamin B12 nutritional or Blautia spp. probiotic supplementation, to support the neurodevelopment of infants at risk for experiencing racial disparities in health.
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Affiliation(s)
| | | | - Rimma Ilyumzhinova
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA
| | - Kimberley Mbayiwa
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA
| | - Anna Sroka
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA
| | - Bingqing Xie
- Department of Medicine, University of Chicago, Chicago, USA
| | - Bree Andrews
- Department of Pediatrics, University of Chicago, Chicago, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA
| | - Erika C. Claud
- Department of Pediatrics, University of Chicago, Chicago, USA
- Department of Medicine, University of Chicago, Chicago, USA
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13
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Jiang L, Hu X, Jin J, Wang W, Yu B, Chen G, Dong H, Zhou Y. Inflammatory Risk Status Shapes the Association Between Uric Acid and Cognitive Function in Non-Hyperuricemia Middle Aged and Elderly. J Alzheimers Dis 2024; 97:249-257. [PMID: 38043014 DOI: 10.3233/jad-230841] [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: 12/04/2023]
Abstract
BACKGROUND The association between uric acid (UA) and cognitive function still remains controversial. Moreover, the role of inflammation in the above association is also unclear. OBJECTIVE We aimed to determine the association between UA and cognitive function among non-hyperuricemia adults, and in particular, whether the association was shaped by different inflammation levels. METHODS From the China Health and Retirement Longitudinal Study (CHARLS), 7,272 participants aged 45 and above were enrolled in 2011. Cognitive function measurement included orientation and attention, episodic memory, and visuospatial ability. Fasting blood samples were collected to measure levels of UA and high-sensitivity C-reactive protein (hs-CRP). Generalized estimating equation models were used to evaluate the effect of UA on cognitive function in all participants and those at different levels of hs-CRP (hs-CRP <3 mg/L or ≥3 mg/L). RESULTS Among non-hyperuricemia adults (mean age: 58.08, 49.59% males) for a median of 7 years follow-up, participants with higher levels of UA had better cognitive function score compared to those with lower UA levels (β: 0.09, 95% confidence interval [CI]: 0.01-0.17, p = 0.023). And this association was significant under low-grade inflammation levels condition (β:0.10, 95% CI: 0.10-0.19, p = 0.024), but not in high-grade inflammation levels condition. Further, the cognitive function benefit of elevated UA existed only in people with persistent low-grade inflammation levels at a longitudinal perspective (β: 0.14, 95% CI: 0.01-0.27, p = 0.039). CONCLUSIONS Elevated UA levels were associated with better cognitive function in non-hyperuricemia population, especially for those at low inflammation levels.
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Affiliation(s)
- Lujing Jiang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Junguo Jin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Weimian Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Bingyan Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Guo Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Nyingchi People's Hospital, Nyingchi, Tibet, China
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
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14
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Zhou Y, Wen J, Yang Z, Zeng R, Gong W, Jing Q. The potential relationship between uric acid and the recovery in sudden sensorineural hearing loss. Braz J Otorhinolaryngol 2024; 90:101368. [PMID: 38006724 PMCID: PMC10724551 DOI: 10.1016/j.bjorl.2023.101368] [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: 08/11/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE Serum uric acid is proven to be associated with chronic hearing loss, but its effect on Sudden Sensorineural Hearing Loss (SSNHL) is unclear. This study aims to evaluate the prognostic values of serum uric acid levels in SSNHL patients. METHODS The clinical records of SSNHL patients were retrospectively reviewed. Patients were divided into different groups based on hearing recovery and audiogram type, and uric acid levels were compared. Based on uric acid levels, patients were categorized into normouricemia and hyperuricemia groups, and clinical features and hearing recovery were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS In total, 520 SSNHL patients were included in this study, including 226 females and 294 males. In female patients, 186 patients were included in the normouricemia group, and 40 patients were enrolled in the hyperuricemia group. Significant differences were observed in uric acid levels, Total Cholesterol (TC), rate of complete recovery, and slight recovery between the two groups. In male patients, 237 subjects were categorized into the normouricemia group, and 57 patients were included in the hyperuricemia group. The rate of complete recovery and slight recovery was lower in the hyperuricemia group compared to the normouricemia group. All patients were further divided into good recovery and poor recovery groups based on hearing outcomes. The uric acid levels, initial hearing threshold, rate of hyperuricemia, and TC were lower in the good recovery group than the poor recovery group both in female and male patients. Binary logistic regression results showed that uric acid levels, initial hearing threshold, and hyperuricemia were associated with hearing recovery. CONCLUSION Hyperuricemia might be an independent risk factor for hearing recovery in SSNHL patients. Serum uric acid and initial hearing threshold possibly affected the hearing outcome in males and females with SSNHL. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Yandan Zhou
- Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, Hunan, China
| | - Jie Wen
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Zhongchun Yang
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Ruifang Zeng
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Wei Gong
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Qiancheng Jing
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital and Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China.
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15
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Zhang C, Wang Y, Li D, Li M, Zhang X, Rong W, Wang P, Li L, He S, Xu Y, Li Y. EEG Power Spectral Density in NREM Sleep is Associated with the Degree of Hypoxia in Patients with Obstructive Sleep Apnea. Nat Sci Sleep 2023; 15:979-992. [PMID: 38046177 PMCID: PMC10691959 DOI: 10.2147/nss.s433820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder. Research conducted on patients with OSA using electroencephalography (EEG) has revealed a noticeable shift in the overnight polysomnography (PSG) power spectrum. To better quantify the effects of OSA on brain function and to identify the most reliable predictors of pathological cortical activation, this study quantified the PSG power and its association with the degree of hypoxia in OSA patients. Patients and Methods This retrospective study recruited 93 patients with OSA. OSA patients were divided into three groups based on their apnea-hypopnea index (AHI) scores. The clinical characteristics and sleep macrostructure of these patients were examined, followed by an analysis of PSG signals. Power spectral density (PSD) in five frequency bands was analyzed during nonrapid eye movement (NREM) sleep, rapid eye movement (REM) sleep, and wakefulness. Finally, correlation analysis was conducted to assess the relationships among PSD, PSG parameters, and serum levels of S100β and uric acid. Results Obstructive sleep apnea occurred during both the NREM and REM sleep phases. Except for a decrease in the duration of N2 sleep and an increase in the microarousal index, there were no significant differences in sleep architecture based on disease severity. Compared to the mild OSA group, the theta and alpha band PSD in the frontal and occipital regions during NREM sleep and wakefulness were significantly decreased in the moderate and severe OSA groups. Correlation analysis revealed that theta PSD in N1 and N3 stages were negatively correlated the AHI, oxygen desaturation index, SaO2<90% and microarousal index. Conclusion These findings imply that patients with more severe OSA exhibited considerable NREM hypoxia and abnormal brain activity in the frontal and occipital regions. Therefore, sleep EEG oscillation may be a useful neurophysiological indicator for assessing brain function and disease severity in patients with OSA.
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Affiliation(s)
- Chan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Yanhui Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- The Academy of Medical Sciences of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Dongxiao Li
- Henan Neurodevelopment Engineering Research Center for Children, Henan Key Laboratory of Children’s Genetics and Metabolic Diseases, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, 450018, People’s Republic of China
| | - Mengjie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- The Academy of Medical Sciences of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Xiaofeng Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Wenzheng Rong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Pu Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
| | - Lanjun Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Shujing He
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People’s Republic of China
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16
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Liu Q, Peng M, Yang T, Si G. Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies. PLoS One 2023; 18:e0293832. [PMID: 37917590 PMCID: PMC10621826 DOI: 10.1371/journal.pone.0293832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE Studying the effects of uric acid levels on cognitive function and quantifying the dose-response relationship. METHODS Based on PubMed and Embase search terms, we identified prospective cohort studies that included blood uric acid as a risk factor and cognitive impairment as a result up to September 2022. We extracted pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs). RESULTS Nine reports (including 488,915 participants and 5516 cognitive impairment cases) with median follow-up of 8.8-22 years were eligible for analyses. Compared with lowest category of blood uric acid concentration, the combined RR of cognitive impairment events in the highest classification was 0.81 (95% CI: 0.70-0.92, P < 0.001). Dose-response analysis of eight reports (including 484,297 participants and 5059 cognitive impairment cases) showed that there was no evidence of a curvilinear relationship between blood uric acid levels and cognitive impairment (P = 0.51 for nonlinear relationship). The summary RR of cognitive impairment for an increase of 1 mg/dL blood uric acid level was 0.98 (95% CI: 0.95-1.00; linear trend P = 0.07, I2 = 67.1%, heterogeneity P < 0.05). There was also a linear negative association between blood uric acid levels and cognitive impairment risk in the male subgroup analysis (RR = 0.97, 95% CI: 0.95-0.99, P < 0.05). CONCLUSION Levels of blood uric acid are not related to risk of cognitive impairment. A subgroup analysis shows that the rise in blood uric acid levels in the male population is related to a decreased risk of cognitive impairment. These results need to be confirmed by further studies.
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Affiliation(s)
- Qianqian Liu
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Chinese and Western Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Min Peng
- Department of Chinese and Western Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Tiantian Yang
- Department of Chinese and Western Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guomin Si
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Chinese and Western Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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17
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Xu L, Ouyang QR, Xiong Q, Huang LW, Yu M. Elevated serum uric acid is associated with cognitive impairment in acute minor ischemic stroke patients. Heliyon 2023; 9:e21072. [PMID: 37886747 PMCID: PMC10597847 DOI: 10.1016/j.heliyon.2023.e21072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/26/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
Background Acute minor ischemic stroke (AMIS) has been proven to be strongly associated with post-stroke cognitive impairment (PSCI). Few studies have reported that uric acid (UA) levels are linked to PSCI in patients with AMIS, and those results are debatable. We investigated the relationship between serum UA levels and cognitive impairment in patients with AMIS. Methods A total of 318 patients who were diagnosed with AMIS were recruited from Suining Central Hospital. Fasting serum samples were collected the day after admission for UA measurement. Cognitive function was evaluated at admission and 3 months after stroke using the Montreal Cognitive Assessment (MoCA). The relationship between UA and PSCI was examined using a multivariate binary logistic regression model. The optimal cut-off point for UA levels to predict PSCI was determined using the receiver operating characteristic (ROC) curve. Results A total of 197 (61.9 %) of the 318 participants in this study exhibited cognitive impairment at 3 months. Serum UA was strongly linked with PSCI after adjusting for confounding factors (OR = 1.82, 95 % CI: 1.56 to 2.11, P < 0.0001). The ROC curve revealed a cut-off of 363.58 μmol/L serum UA, and the predicted sensitivity and specificity for PSCI were 67.5 % and 83.5 %, respectively. Subgroup analysis showed that confounding factors had no impact on the association between serum UA and PSCI risk. Conclusions Higher baseline serum UA levels might be an independent risk factor for cognitive impairment in AMIS patients. Serum UA levels above 363.58 μmol/L may have clinical implications in predicting PSCI.
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Affiliation(s)
- Lei Xu
- Department of Neurology, Suining Central Hospital, Suining, 629000, China
| | - Qing-rong Ouyang
- Department of Neurology, Suining Central Hospital, Suining, 629000, China
| | - Qin Xiong
- Department of Internal Medicine, The Third People's Hospital of Suining, Suining, 629099, China
| | - Lu-wen Huang
- Department of Neurology, Suining Central Hospital, Suining, 629000, China
| | - Ming Yu
- Department of Neurology, Suining Central Hospital, Suining, 629000, China
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18
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Khaled Y, Abdelhamid AA, Al-Mazroey H, Almannai AK, Fetais S, Al-Srami AS, Ahmed S, Al-Hajri N, Mustafa A, Chivese T, Djouhri L. Higher serum uric acid is associated with poorer cognitive performance in healthy middle-aged people: a cross-sectional study. Intern Emerg Med 2023; 18:1701-1709. [PMID: 37330420 PMCID: PMC10504193 DOI: 10.1007/s11739-023-03337-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/01/2023] [Indexed: 06/19/2023]
Abstract
Age-related cognitive impairment can occur many years before the onset of the clinical symptoms of dementia. Uric acid (UA), a metabolite of purine-rich foods, has been shown to be positively associated with improved cognitive function, but such association remains controversial. Moreover, most of the previous studies investigating the association included elderly participants with memory-related diseases. Therefore, the present study aimed at investigating whether serum UA (sUA) is associated with cognitive performance in healthy middle-aged individuals. We conducted a cross-sectional study on a cohort of middle-aged individuals (40-60 years old) who participated in the Qatar Biobank. The participants had no memory-related diseases, schizophrenia, stroke, or brain damage. They were divided according to sUA level into a normal group (< 360 μmol/L) and a high group (≥ 360 μmol/L), and underwent an assessment of cognitive function using the Cambridge Neuropsychological Test Automated Battery. Two cognitive function domains were assessed: (a) speed of reaction/reaction time and (b) short-term visual memory. The median age of the 931 participants included in the study was 48.0 years (IQR: 44.0, 53.0), of which 47.6% were male. Adjusted multivariable linear regression analyses showed that higher sUA is associated with poorer performance on the visual memory domain of cognitive function (β = - 6.87, 95% CI - 11.65 to - 2.10, P = 0.005), but not on the speed of reaction domain (β = - 55.16, 95% CI - 190.63 to 80.30, P = 0.424). Our findings support previous studies suggesting an inverse association between high sUA levels and cognitive function in elderly and extend the evidence for such a role to middle-aged participants. Further prospective studies are warranted to investigate the relationship between UA and cognition.
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Affiliation(s)
- Yousef Khaled
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Aya A Abdelhamid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Hissa Al-Mazroey
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Abdulrahman K Almannai
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Sara Fetais
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Aisha S Al-Srami
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Shaima Ahmed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Noora Al-Hajri
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ayman Mustafa
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
| | - Tawanda Chivese
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Laiche Djouhri
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar.
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19
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Hussein S, Pingili S, Makkena VK, Jaramillo AP, Awosusi BL, Ayyub J, Dabhi KN, Gohil NV, Tanveer N, Hamid P. The Impact of Serum Uric Acid on the Progression of Amyotrophic Lateral Sclerosis in Adults Aged 18 and Older: A Systematic Review. Cureus 2023; 15:e42312. [PMID: 37614251 PMCID: PMC10444204 DOI: 10.7759/cureus.42312] [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: 06/03/2023] [Accepted: 07/22/2023] [Indexed: 08/25/2023] Open
Abstract
We have conducted this review to see if serum uric acid (UA) is associated with slowing amyotrophic lateral sclerosis (ALS) progression in adult patients who are at least 18 years old. Understanding the effects of this biomarker for future use is critical because of its easy accessibility. This systematic review paper examined five previous years of recent studies and reports, published in English and limited to human investigations from the Cochrane, PubMed, and Google Scholar databases. Using instruments for assessing the eligibility and quality of systematic and narrative reviews, we narrowed our search to 11 reports that show evidence of a positive association between high blood uric acid and the progression of ALS. However, this claim still needs confirmation by future studies to confirm that possibility. The results of this systematic review may provide a strong foundation for future studies on this biomarker, demonstrating the significance of blood uric acid levels in ALS and highlighting the necessity of using that biomarker to track the disease's progression.
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Affiliation(s)
- Sally Hussein
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Shravya Pingili
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Medicine/Surgery, Kakatiya Medical College, Hyderabad, IND
| | - Vijaya Krishna Makkena
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Medicine/Surgery, Osmania Medical College, Hyderabad, IND
| | - Arturo P Jaramillo
- General Practice, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Babatope L Awosusi
- Pathology and Laboratory Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Javaria Ayyub
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Karan Nareshbhai Dabhi
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Namra V Gohil
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Internal Medicine, Medical College Baroda, Vadodara, IND
| | - Nida Tanveer
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Internal Medicine, University of Louisville, Louisville, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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20
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Borovcanin MM, Vesic K, Petrovic I, Jovanovic IP, Mijailović NR. Diabetes mellitus type 2 as an underlying, comorbid or consequent state of mental disorders. World J Diabetes 2023; 14:481-493. [PMID: 37273248 PMCID: PMC10236997 DOI: 10.4239/wjd.v14.i5.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/21/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Somatic disturbances that occur in parallel with psychiatric diseases are a major challenge in clinical practice. Various factors contribute to the development of mental and somatic disorders. Type 2 diabetes mellitus (T2DM) is a significant health burden worldwide, and the prevalence of diabetes in adults is increasing. The comorbidity of diabetes and mental disorders is very common. By sharing a bidirectional link, both T2DM and mental disorders influence each other in various manners, but the exact mechanisms underlying this link are not yet elucidated. The potential mechanisms of both mental disorders and T2DM are related to immune and inflammatory system dysfunction, oxidative stress, endothelial dysfunction, and metabolic disturbances. Moreover, diabetes is also a risk factor for cognitive dysfunction that can range from subtle diabetes-associated cognitive decline to pre-dementia and dementia. A complex re-lationship between the gut and the brain also represents a new therapeutic approach since gut-brain signalling pathways regulate food intake and hepatic glucose production. The aim of this minireview is to summarize and present the latest data on mutual pathogenic pathways in these disorders, emphasizing their complexity and interweaving. We also focused on the cognitive performances and changes in neurodegenerative disorders. The importance of implementing integrated approaches in treating both of these states is highlighted, along with the need for individual therapeutic strategies.
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Affiliation(s)
- Milica M Borovcanin
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Katarina Vesic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Ivica Petrovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Ivan P Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
| | - Nataša R Mijailović
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34 000, Serbia
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Yuan Z, Liu H, Zhou R, Gu S, Wu K, Huang Z, Zhong Q, Huang Y, Chen H, Wu X. Association of serum uric acid and fasting plasma glucose with cognitive function: a cross-sectional study. BMC Geriatr 2023; 23:271. [PMID: 37142950 PMCID: PMC10161633 DOI: 10.1186/s12877-023-03998-9] [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: 10/12/2022] [Accepted: 04/24/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The combined effect of serum uric acid (SUA) and blood glucose on cognition has not been explored. This study aimed to examine the separate and combined association of SUA and fasting plasma glucose (FPG) or diabetes mellitus (DM) with cognition in a sample of Chinese middle-aged and elderly population. METHODS A total of 6,509 participants aged 45 years or older who participated in the China Health and Retirement Longitudinal Study (CHARLS, 2011) were included. The three cognitive domains assessed were episodic memory, mental status, and global cognition (the sum of the first two terms). Higher scores indicated better cognition. SUA and FPG were measured. The participants were grouped based on SUA and FPG quartiles to evaluate their combined associations of cognition with SUA Q1-Q3 only (Low SUA), with FPG Q4 only (High FPG), without low SUA and high FPG levels (Non), and with low SUA and high FPG levels (Both), multivariate linear regression models were used to analyze their association. RESULTS Lower SUA quartiles were associated with poorer performance in global cognition and episodic memory compared with the highest quartile. Although no association was found between FPG or DM and cognition, high FPG or DM combined with low SUA levels in women (βFPG = -0.983, 95% CI: -1.563--0.402; βDM = -0.800, 95% CI: -1.369--0.232) had poorer cognition than those with low SUA level only (βFPG = -0.469, 95% CI: -0.926--0.013; βDM = -0.667, 95% CI: -1.060--0.275). CONCLUSION Maintaining an appropriate level of SUA may be important to prevent cognitive impairment in women with high FPG.
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Affiliation(s)
- Zelin Yuan
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Huamin Liu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Shanyuan Gu
- Department of Psychiatry, Baiyun Psychiatric Rehabilitation Hospital, No.2 Helong Five Road, Guangzhou, 510445, Guangdong, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Yining Huang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Haowen Chen
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Diseases, Southern Medical University, Guangzhou, China.
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22
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Zhang C, Zhang X, Meng P, Gao H, Bai B, Li D. The association between serum uric acid and cognitive performance in patients with ischemic stroke is modified by estimated glomerular filtration rate. Sci Rep 2023; 13:7097. [PMID: 37130897 PMCID: PMC10154290 DOI: 10.1038/s41598-023-34352-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023] Open
Abstract
The relationship between serum uric acid (SUA) and poor cognitive performance in patients with ischemic stroke is unclear. We hypothesized that the severity of renal function mediates the association between SUA and cognitive dysfunction.A retrospective analysis of 608 patients with ischemic stroke was conducted between 2016 and 2020. SUA was obtained from inpatient medical records. Global cognitive function via mini-mental state exam (MMSE) and Montreal Cognitive Assessment (MoCA) was determined one month after hospital discharge. The relationship between SUA and cognitive function was assessed by multiple linear and logistic regression analyses. Patients had a mean age of 66.6 years (SD: 4.1 years), and 52% were male. The mean SUA level was 298.6 ± 75.4 μmol/L. SUA increases were significantly positively associated with lower MMSE and MoCA scores and increased risk of moderate-severe cognitive impairment one month after stroke (p < 0.01), even after adjusting for factors including age, gender, BMI, diabetes and hypertension history. Adding a term for estimated glomerular filtration rate (eGFR) attenuated these associations such that SUA was no longer associated with cognitive performance. A fully adjusted stronger negative association between SUA and cognitive performance was found in those who had lower eGFR, with a significant eGFR interaction for MMSE (p-interaction = 0.016) and MoCA (p-interaction = 0.005). In patients with ischemic stroke, SUA showed an inverse association with cognitive function among those who have lower eGFR. The renal function might mediate the association between SUA and cognitive dysfunction.
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Affiliation(s)
- Chunyan Zhang
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Xiuping Zhang
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Pengfei Meng
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Huizhong Gao
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Bo Bai
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Dongfang Li
- Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.
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23
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Yuan Z, Liu H, Zhang X, He Y, Gu S, Mo D, Wang S, Huang Z, Wu K, Zhou R, Zhong Q, Huang Y, Cao B, Chen H, Wu X. Role of uric acid as a biomarker of cognitive function in schizophrenia during maintenance period. Front Psychiatry 2023; 14:1123127. [PMID: 37032942 PMCID: PMC10073439 DOI: 10.3389/fpsyt.2023.1123127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Background Previous studies involving uric acid (UA) in some specialized disease populations have found that high UA is associated with enhanced patient function. The mechanism to explain this association may be that UA, an important antioxidant, exerts neuroprotective effects. Patients with schizophrenia (SCZ) have severe oxidative stress abnormalities, and cognitive impairment is a major obstacle to their rehabilitation. Only few studies have been conducted on UA and cognitive impairment in SCZ. This study aims to clarify the relationship between UA and cognitive impairment and explore whether UA could be used as a potential biological marker of cognition in SCZ during maintenance period. Methods A total of 752 cases of SCZ during maintenance period from Baiyun Jingkang Hospital were included. Cognition was measured using the Mini-Mental State Examination scale. UA was measured using the Plus method. The participants were grouped on the basis of UA to evaluate the association of cognition with low-normal (3.50-5.07 mg/dL for men, 2.50-4.19 mg/dL for women), middle-normal (5.07-6.39 mg/dL for men, 4.19-5.18 mg/dL for women), high-normal (6.39-7.00 mg/dL for men, 5.18-6.00 mg/dL for women), and high (>7.00 mg/dL for men, >6.00 mg/dL for women) levels of UA. Multiple logistic regression and linear regression models and restricted cubic spline (RCS) were utilized to evaluate the relationship. Results Uric acid was positively associated with cognitive function. Subgroup analyses showed that high UA was associated with enhanced cognition in participants with low anticholinergic cognitive burden (ACB). Conclusion Uric acid may be used as a simple objective biological indicator to assess cognition in SCZ during maintenance period.
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Affiliation(s)
- Zelin Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Huamin Liu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xiaochun Zhang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Yong He
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shanyuan Gu
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Dan Mo
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shaoli Wang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Yining Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Bifei Cao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Haowen Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
- *Correspondence: Xianbo Wu, ; orcid.org/0000-0002-2706-9599
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24
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Fazlollahi A, Zahmatyar M, Alizadeh H, Noori M, Jafari N, Nejadghaderi SA, Sullman MJM, Gharagozli K, Kolahi AA, Safiri S. Association between gout and the development of Parkinson's disease: a systematic review and meta-analysis. BMC Neurol 2022; 22:383. [PMID: 36221048 PMCID: PMC9552480 DOI: 10.1186/s12883-022-02874-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND As a natural antioxidant, uric acid plays a protective role against neurodegenerative disorders, including Parkinson's disease (PD). Therefore, the risk of PD has been found to be lower in people with hyperuricemia. In this article, we conducted a systematic review and meta-analysis to investigate whether gout affects the future risk of developing PD. METHODS We searched PubMed, Scopus, the Web of Science, and Google Scholar to find relevant studies, up to March 16, 2022. Studies investigating the risk of PD, following a gout diagnosis, were included if they were cross-sectional, case-control or cohort studies. The Newcastle Ottawa Scale (NOS) checklist was used to assess the quality of all included studies. The meta-analysis was performed using STATA 17.0. RESULTS Ten studies were included, which were comprised of three case-controls, six cohort studies and one nested case-control study. We found no significant association between gout and the risk of PD among both sexes (RR = 0.94, 95% CI: 0.86-1.04), although the association was significant for females (RR = 1.09; 95% CI: 1.02-1.17). Subgroup analysis also showed no significant findings by age group, whether they were receiving treatment for gout, study design, quality assessment score, and method of gout ascertainment. In contrast, the studies that defined PD according to the use of drugs showed significant results (RR = 0.82; 95% CI: 0.76-0.89). There was a significant publication bias on the association between gout and PD. CONCLUSIONS The presence of gout had no significant effect on the risk of subsequently developing PD. Further analyses are recommended to investigate the effects of demographic and behavioral risk factors.
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Affiliation(s)
- Asra Fazlollahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Zahmatyar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Alizadeh
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Jafari
- Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Koroush Gharagozli
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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