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Hyperuricemia, Gout, and the Brain-an Update.
Augustin Latourte1,2, Julien Dumurgier3, Claire Paquet3
1Université de Paris, INSERM, UMR-S, 1132 BIOSCAR, 75010, Paris, France. augustin.latourte@aphp.fr.
Current Rheumatology Reports
|December 31, 2021
Summary
This review explores the link between uric acid (UA), gout, and brain health. Current evidence suggests UA and gout may not causally impact neurodegenerative diseases or stroke.
Area of Science:
- Neurology
- Rheumatology
- Genetics
Background:
- Hyperuricemia and gout are linked to various health conditions.
- Observational studies suggest complex associations between uric acid levels and brain diseases, including neurodegenerative and cerebrovascular conditions.
- The causal relationship remains unclear.
Purpose of the Study:
- To review current evidence on the relationship between uric acid (UA), gout, and brain diseases.
- To critically evaluate findings from observational and Mendelian randomization (MR) studies.
- To identify gaps in knowledge and suggest future research directions.
Main Methods:
- Systematic review of observational studies and Mendelian randomization (MR) analyses.
- MR studies utilize genetic variants as instrumental variables to infer causality.
- Analysis focused on associations between UA/gout and Alzheimer's disease, dementia, Parkinson's disease, and stroke.
Main Results:
- Observational studies suggest a potential decreased risk of neurodegenerative diseases but an increased risk of cerebrovascular disease in individuals with hyperuricemia or gout.
- MR analyses do not support a causal link between UA or gout and Alzheimer's disease, dementia, or Parkinson's disease.
- MR studies also do not support a causal association between UA and stroke, nor the observed U-shaped association between UA and brain diseases.
Conclusions:
- Current genetic evidence does not support a causal role for uric acid or gout in major brain diseases like Alzheimer's, dementia, or Parkinson's.
- The observed associations in observational studies may not reflect causality.
- Further research is needed to clarify the causal role of gout and the effects of urate-lowering therapies on neurological outcomes.
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