Abstract
BackgroundEvidence has shown that serum uric acid (UA) is associated with cognitive function, but this finding remains debatable. Serum UA is commonly elevated in patients with chronic heart failure (CHF), especially in men. However, the relationship between serum UA and cognitive function in CHF populations and stratified by sex are unclear. We aimed to examine whether serum UA was independently associated with cognitive function in CHF populations after controlling for demographic, medical and psychological variables and whether there was a sex difference in the association between serum UA and cognitive function among male and female CHF patients.MethodsOne hundred ninety-two hospitalized patients with CHF underwent an assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) and the determination of serum UA. Hyperuricemia was defined as serum UA ≥7 mg/dl in men and ≥ 6 mg/dl in women. Multiple linear hierarchical regression analyses were conducted to examine the independent association between serum UA and cognitive function in CHF populations and stratified by sex.ResultsThe mean serum UA concentration of participants was 7.3 ± 2.6 mg/dL. The prevalence of hyperuricemia was 54.7% (105 of 192) in CHF patients, 52.9% (64 of 121) in men, and 57.7% (41 of 71) in women. In the total sample, higher serum UA was associated with poorer cognitive function independent of demographic, medical and psychological variables (β = − 0.130, ΔR2 = 0.014, p = 0.015). In sex-stratified groups, elevated serum UA was independently associated with worse cognitive function in men (β = − 0.247, ΔR2 = 0.049, p = 0.001) but not in women (β = − 0.005, ΔR2 = 0.000, p = 0.955).ConclusionsHigher serum UA is independently associated with poorer cognitive function in CHF populations after adjusting for confounding variables. Furthermore, elevated serum UA is independently related to worse performance on cognitive function in men but not in women. More longitudinal studies are needed to examine the association between serum UA and cognitive function in CHF populations and stratified by sex.
Highlights
Evidence has shown that serum uric acid (UA) is associated with cognitive function, but this finding remains debatable
To the best of our knowledge, the current study is the first to show that elevated serum UA is independently associated with poorer performance on cognitive function in chronic heart failure (CHF) patients after adjusting for demographic, medical, Table 2 A hierarchical regression of serum UA predicting cognitive function in patients with CHF (n = 192)
UA uric acid, CHF chronic heart failure, NYHA New York Heart Association, left ventricular ejection fraction (LVEF) left ventricular fraction, Body mass index (BMI) body mass index, hs-CRP hypersensitive C-reactive protein, eGFR estimated glomerular filtration rate, Self-Rating Depression Scale (SDS) self-rating depression scale β standardized coefficients, confidence intervals (CI) confidence interval * P < 0.05; ** P < 0.01 and psychological characteristics. Another new finding of the present study is that elevated serum UA is independently associated with poorer performance on cognitive function in male CHF patients but not in female CHF patients
Summary
Evidence has shown that serum uric acid (UA) is associated with cognitive function, but this finding remains debatable. Serum UA is commonly elevated in patients with chronic heart failure (CHF), especially in men. The relationship between serum UA and cognitive function in CHF populations and stratified by sex are unclear. Cognitive impairment is associated with adverse outcomes in CHF patients, including poor self-care [5], poor medication [6] and treatment adherence [7], and high mortality [8]. Previous work has demonstrated that many medical comorbidities play an important role in the pathogenesis of cognitive impairment in CHF patients, including hypertension [9], type 2 diabetes mellitus [10], atrial fibrillation [11], obesity [12], chronic renal dysfunction [13], anemia [14], hyponatremia [15], depression [16], and sleep apnea [17].
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