알츠하이머병에서 백질 변화 정도에 따른 혈중 요산수치
Serum Uric Acid Level according to the Severity of White Matter Changes in Alzheimer’s Disease
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: Uric acid (UA) is now recognized as a natural antioxidant that has neuroprotective properties. While it has beneficial properties, it may directly induce inflammation and vascular events such as atherosclerosis and stroke. In this study, we examined the relation between serum UA level and the burden of hyperintense signals of the cerebral white matter (WM) on Fluid attenuated inversion recovery (FLAIR) in Alzheimer’s disease (AD). Methods: The participants in this study consisted of 71 healthy controls and 129 patients with AD. To assess WM ischemic changes in AD patients, deep white matter (DWM) and periventricular white matter (PVWM) changes were scored as separately, and then their sums were also rated. UA levels were compared between a control and AD group. By using analysis of covariance, we investigated the difference of UA level depending on the clinical WM rating scale. The correlation between WM changes and UA levels was also analyzed. Results: There was significant difference in UA level between the control and AD group (5.59±1.15 mg/dL vs. 4.67±1.16 mg/dL; p=0.001). However, within AD patients, there were no significant differences in UA levels according to the severity of WM changes (4.57±1.22 mg/dL, 4.74±1.03 mg/dL, 4.37±1.39 mg/dL for DWM scores 1,2,3; p=0.28, 4.58±1.24 mg/dL, 4.56±1.05 mg/dL, 4.91±1.15 mg/dL for PVWM scores 1,2,3; p=0.33 and 4.60±1.20 mg/dL, 4.74±1.06 mg/dL, 4.33±1.40 mg/dL for clinical WM rating scales 1,2,3; p=0.29). There was no correlation between the score of Korean version mini-mental status examination and uric acid. Conclusions: The serum UA was decreased in the AD patients regardless of WM rating scores, compared with healthy controls. However, based on the result that showed no difference according to the severity of WM change, it should be considered several possible explanations. These suggest that there is seldom relationship between UA and the burden of WM in AD, although the oxidative injuries play an important role in the pathogenesis of AD.
Abstract
Background: Uric acid (UA) is now recognized as a natural antioxidant that has neuroprotective properties. While it has beneficial properties, it may directly induce inflammation and vascular events such as atherosclerosis and stroke. In this study, we examined the relation between serum UA level and the burden of hyperintense signals of the cerebral white matter (WM) on Fluid attenuated inversion recovery (FLAIR) in Alzheimer’s disease (AD). Methods: The participants in this study consisted of 71 healthy controls and 129 patients with AD. To assess WM ischemic changes in AD patients, deep white matter (DWM) and periventricular white matter (PVWM) changes were scored as separately, and then their sums were also rated. UA levels were compared between a control and AD group. By using analysis of covariance, we investigated the difference of UA level depending on the clinical WM rating scale. The correlation between WM changes and UA levels was also analyzed. Results: There was significant difference in UA level between the control and AD group (5.59±1.15 mg/dL vs. 4.67±1.16 mg/dL; p=0.001). However, within AD patients, there were no significant differences in UA levels according to the severity of WM changes (4.57±1.22 mg/dL, 4.74±1.03 mg/dL, 4.37±1.39 mg/dL for DWM scores 1,2,3; p=0.28, 4.58±1.24 mg/dL, 4.56±1.05 mg/dL, 4.91±1.15 mg/dL for PVWM scores 1,2,3; p=0.33 and 4.60±1.20 mg/dL, 4.74±1.06 mg/dL, 4.33±1.40 mg/dL for clinical WM rating scales 1,2,3; p=0.29). There was no correlation between the score of Korean version mini-mental status examination and uric acid. Conclusions: The serum UA was decreased in the AD patients regardless of WM rating scores, compared with healthy controls. However, based on the result that showed no difference according to the severity of WM change, it should be considered several possible explanations. These suggest that there is seldom relationship between UA and the burden of WM in AD, although the oxidative injuries play an important role in the pathogenesis of AD.
참고문헌 (28)
- Zhu X, "Smith M. Alzheimer’s disease: the two-hit hypothesis", Lancet Neurol, 3, pp.219~226 (2004)
- Mariani E, "Oxidative stress in brain aging, neurodegenerative and vascular diseases: an overview", J Chromatogr B Analyt Technol Biomed Life Sci, 827, pp.65~75 (2005)
- Mecocci P, "Oxidative damage to mitochondrial DNA is increased in Alzheimer’s disease", Ann Neurol, 36, pp.747~751 (1994)
- Jellinger K, "Prevalence and pathogenic role of cerebrovascular lesions in Alzheimer disease", J Neurol Sci, 229, pp.37~41 (2005)
- Jellinger K, "The impact of cerebrovascular lesions in Alzheimer disease--a comparative autopsy study", J Neurol, 250, pp.1050~1055 (2003)
- Fazekas F, "Pathophysiologic mechanisms in the development of age-related white matter changes of the brain", Dement Geriatr Cogn Disord, 9(1), pp.2~5 (1998)
- Keller J, "Evidence of increased oxidative damage in subjects with mild cognitive impairment", Neurology, 64, pp.1152~1156 (2005)
- Euser SM, "Serum uric acid and cognitive function and dementia", Brain, 132, pp.377~382 (2009)
- Rinaldi P, "Plasma antioxidants are similarly depleted in mild cognitive impairment and in Alzheimer’s disease", Neurobiol Aging, 24, pp.915~919 (2003)
- Kim TS, "Decreased plasma antioxidants in patients with Alzheimer’s disease", Int J Geriatr Psychiatry, 21, pp.344~348 (2006)
- Polidori M, "Plasma antioxidant status, immunoglobulin g oxidation and lipid peroxidation in demented patients: relevance to Alzheimer disease and vascular dementia", Dement Geriatr Cogn Disord, 18, pp.265~270 (2004)
- Schiess M, "Serum uric acid and clinical progression in Parkinson disease: potential biomarker for nigrostriatal failure", Arch Neurol, 65, pp.698~699 (2008)
- de LL, "Serum uric acid levels and the risk of Parkinson disease", Ann Neurol, 58, pp.797~800 (2005)
- Patterson RA, "Prooxidant and antioxidant properties of human serum ultrafiltrates toward LDL: important role of uric acid", J Lipid Res, 44, pp.512~521 (2003)
- Becker B, "Towards the physiological function of uric acid", Free Radic Biol Med, 14, pp.615~631 (1993)
- Lehto S, "Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus", Stroke, 29, pp.635~639 (1998)
- Culleton B, "Serum uric acid and risk for cardiovascular disease and death: the framingham heart study", Ann Intern Med, 131, pp.7~13 (1999)
- Hayden M, "Uric acid: a new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: the urate redox shuttle", Nutr Metab (Lond), 1, pp.10~ (2004)
- Hozawa A, "Serum uric acid and risk of ischemic stroke: the aric study", Atherosclerosis, 187, pp.401~407 (2006)
- Weir C, "Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke", Stroke, 34, pp.1951~1956 (2003)
- Chamorro A, "Prognostic significance of uric acid serum concentration in patients with acute ischemic stroke", Stroke, 33, pp.1048~1052 (2002)
- Cherubini A, "Antioxidant profile and early outcome in stroke patients", Stroke, 31, pp.2295~2300 (2000)
- Schretlen D, "Serum uric acid and cognitive function in community-dwelling older adults", Neuropsychology, 21, pp.136~140 (2007)
- Vannorsdall TD, "Cerebral ischemia mediates the effect of serum uric acid on cognitive function", Stroke, 39, pp.3418~3420 (2008)
- Schretlen D, "Serum uric acid and brain ischemia in normal elderly adults", Neurology, 69, pp.1418~1423 (2007)
- McKhann G, "Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease", Neurology, 34, pp.939~944 (1984)
- Gochman N, "Automated determination of uric acid, with use of a uricase-peroxidase system", Clin Chem, 17, pp.1154~1159 (1971)
- Kang Y, "A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~307 (1997)
