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Article type: Research Article
Authors: Huang, Ronga; b | Tian, Saia; b | Han, Jinga | Lin, Hongyana; b | Guo, Dana; b | Wang, Jiaqia; b | An, Kea; b | Wang, Shaohuaa; *
Affiliations: [a] Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China | [b] School of Medicine, Southeast University, Nanjing, PR China
Correspondence: [*] Correspondence to: Shaohua Wang, PhD, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, 210009, PR China. Tel.: +86 25 83262815; Fax: +86 25 83285132; E-mail: gyjwsh@126.com.
Abstract: Background:Serum uric acid (SUA) is a natural antioxidant that may exert neuroprotective effects against neurodegenerative diseases. The relationship between uric acid and cognitive functions has been extensively studied, but results remain conflicting. Objective:To investigate potential associations between SUA level and mild cognitive impairment (MCI), and different domains of cognitive performances in patients with type 2 diabetes mellitus (T2DM). Methods:A total of 352 T2DM subjects (208 males and 144 females) were enrolled. SUA level was determined by using the uricase method. Cognitive performances were assessed using a validated neuropsychological test battery. Generalized additive models and binary logistic regression analysis were fitted to determine the association between SUA and cognitive functions. Results:A total of 157 T2DM patients had MCI, and 195 displayed normal cognition. Compared with the controls, MCI patients exhibited lower SUA level (p = 0.009). Generalized additive models revealed a U-shaped curve relationship among SUA with Montreal Cognitive Assessment, Auditory Verbal Learning Test-immediate recall and Trail Making Test-B scores (all p < 0.05). Further logistic regression analysis showed a significant trend toward decreased MCI risk with increased SUA level among the subjects whose SUA level was below the cut-point (388.63 μmol/L); each unit increment in SUA level reduced the MCI risk by 0.7% (p = 0.003). Conclusion:A U-shaped association between SUA level and global cognitive function, especially executive and memory function, existed in T2DM patients. Our findings will provide additional suggestions that an increase of SUA to a certain level may be a novel method to reduce the burden of T2DM-associated cognitive impairment.
Keywords: Executive function, memory function, mild cognitive impairment, type 2 diabetes mellitus, uric acid
DOI: 10.3233/JAD-181126
Journal: Journal of Alzheimer's Disease, vol. 69, no. 1, pp. 135-144, 2019
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