Relationship between serum uric acid and cerebral white matter lesions in the elderly

Background and Aims: Recent evidence suggests that hyperuricemia might increase the risk of cardiovascular disease. Cardiovascular risk factors are well recognized to be associated with cerebral white matter lesion (WML). We hypothesized that hyperuricemia is related to higher grade of WML in both men and women. Methods and Results: A total of 108 men and 123 women were enrolled from those who signed up for the annual Health Examination for the Elderly Program in Taipei from 2006 to 2008. Information in interview data, clinical and laboratory examinations were collected. Hyperuricemia was defined by uric acid >= 458.0 mu mol/L in men and >= 392.6 mu mol/L in women. Two types of WML including periventricular hyper-intensity (PVH) and deep white matter hyper-intensity (DWMH), ascertained by cranial magnetic resonance imaging, were graded. Association between hyperuricemia and high grade WML was evaluated by using multiple logistic regression analysis. The prevalences of hyperuricemia were 13.9% and 17.9% for men and women, respectively. The prevalences of moderate-to-severe PVH among men and women were 16.7% and 7.3%; while the prevalences of moderate-to-severe DWMH for men and women were 19.4% and 11.4%, respectively. Hyperuricemia was related to moderate-to-severe DWMH in men, after controlling for age, education years, smoking, alcohol consumption, metabolic Z score, silent infarct, and the use of anti-hypertensives, lipid-lowering and anti-diabetic agents, the association remained significant. The relationship was not evident among women. We did not find an association between hyperuricemia and PVH. Conclusions: Hyperuricemia was positively associated with high grade DWMH in older men, but not in women. (C) 2010 Elsevier B.V. All rights reserved