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Uric acid index is a risk for mild cognitive impairment in type 2 diabetes

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Abstract

Background

A new uric acid (UA) index has recently been proposed, while serum uric acid (SUA), fasting triglyceride, and fasting blood glucose levels in the index are shown to affect cognitive function. This study aims to investigate the clinical value of the UA index for assessing mild cognitive impairment (MCI) in type 2 diabetes (T2D) patients.

Methods

This was an observational cross-sectional study with 616 participants. A generalized additive model was used to determine a linear or curvilinear relationship between cognitive performance and the UA index. Logistic regression and random forest models were both developed. A receiver operating characteristic curve (ROC) was delineated and the area under the curve (AUC) was calculated.

Results

MCI was diagnosed in 313 participants (50.81%). Compared with the T2D-normal cognitive function group, MCI subjects had higher UA indexes, lower cognitive scores, and lower education levels (p < 0.001). Generalized additive models showed the UA index and the Montreal Cognitive Assessment (MoCA) score to be decreased linearly (p < 0.001). The UA index AUC was 0.751 (95% CI = 0.713–0.789, p < 0.001). The optimal cut-off point for the identification of MCI based on the UA index was 11.26 (sensitivity: 62.3%, specificity: 75.9%). Results for females in the cohort yielded an AUC change of + 2.5%, the less-educated population (AUC change of + 4.7%), and the hypertensive population (AUC change of + 1.1%). The AUCs were 0.791 (95% CI = 0.720–0.863) for the random forest model and 0.804 (95% CI = 0.770–0.837) for the logistic regression model, and no statistical significance was found (p = 0.758).

Conclusion

This study showed that the increased UA index was independently associated with MCI in patients with T2D, especially among female, less-educated, and hypertensive patients. It could be a potential indicator of MCI in T2D patients.

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Data availability

Some or all datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author upon reasonable request.

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Acknowledgements

Gratitude is expressed to all authors for their efforts and to the participants for their understanding and support of our study.

Funding

This work was supported by a grant from the Fund of Scientific Research Innovation of the First Affiliated Hospital of Harbin Medical University (grant number 2020M27, China).

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Authors and Affiliations

  1. First Affiliated Hospital of Harbin Medical University, Harbin, China

    Xue-Wei Tong, Yi-Tong Zhang, Xin Li, Zi-Wei Yu, Sheng-Dan Pu, Yu-Xin Xu, Yong-Yan Shan & Xin-Yuan Gao

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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by XW-T, YT-Z, ZW-Y, SD-P, XL, YX-Y, and YY-S. The first draft of the manuscript was written by XW-T. XY-G critically reviewed the manuscript for important intellectual content and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xin-Yuan Gao.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University, Harbin, China.

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Informed consent was obtained from all individual participants included in the study.

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Appendix

Appendix

MoCA Test Full and instructions in Chinese (Beijing) version 7.1

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Tong, XW., Zhang, YT., Li, X. et al. Uric acid index is a risk for mild cognitive impairment in type 2 diabetes. Hormones 22, 425–439 (2023). https://doi.org/10.1007/s42000-023-00465-3

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