Relationship between serum bilirubin, uric acid and cognition impairment in patients with subcortical ischemic vascular disease
10.3760/cma.j.issn.1006-7876.2014.05.004
- VernacularTitle:皮质下缺血性血管病患者血清胆红素和尿酸水平与认知损害的关系
- Author:
Xia ZHOU
;
Long WANG
;
Han LIU
;
Zhongwu SUN
- Publication Type:Journal Article
- Keywords:
Brain ischemia;
Cerebral cortex;
Dementia,vascular;
Bilirubin;
Uric acid;
Cognition disorders
- From:
Chinese Journal of Neurology
2014;47(5):305-310
- CountryChina
- Language:Chinese
-
Abstract:
Objective To detect the levels of serum bilirubin and uric acid as well as their relationship with cognitive function in patients with subcortical ischemic vascular disease (SIVD).Methods Serum direct bilirubin (DBIL),indirect bilirubin (IBIL),total bilirubin (TBIL),uric acid (UA) and vascular risk factors were analyzed in 238 individuals comprising 161 patients with SIVD and 77 controls with normal cognitive function.SIVD patients were divided into two subgroups:those with cognitive impairment (SVMCI) and those with dementia (SVaD).All of them were subject to the cognitive assessment including Mini-mental State Examination(MMSE),the Cambridge Cognitive Examination-Chinese Version (CAMCOGC) and Clinical Demential Rating (CDR).Leukoaraiosis was graded according to the severity by their MRI scan appearances.Results MMSE and CAMCOG scores were significant lower in SVMCI and SVaD groups (17.9 ± 5.01,59.87 ± 12.89 ; 24.84 ± 1.57,83.66 ± 4.79) when compared to those in the controls (28.19 ± 1.03,91.66-± 4.93 ; Z =197.63,P =0.000 ; Z =186.54,P =0.000).In comparison with the controls,serum levels of DBIL,IBIL,and TBIL in SVaD group were significant lower ((2.85 ± 1.09) μmol/L vs (3.24 ± 1.30) iμmol/L; (7.50 ±3.27) μmol/L vs (9.06 ±3.52) μmol/L; (10.37 ±4.10) μ mol/L vs (12.31 ±4.64) μmol/L; P =0.035,P =0.005,P =0.006).Also,serum IBIL level was significant lower in SVMCI group compared to the controls ((7.86 ± 3.28) μmol/L vs (9.06 ± 3.52) μmol/L,P =0.034).While serum level of UA was significantly higher in SVMCI ((341.47 ± 92.80) μmol/L) and SVaD ((356.34 ±80.89) μmol/L) groups as compared to those in controls((310.52 ±79.85) μmol/L;P =0.025 ;P =0.001).The UA level was negatively correlated with MMSE scores and CAMCOG-C scores (r =-0.180,P =0.005; r =-0.203,P =0.002),while the bilirubin level was positively correlated with language (r =0.130,P =0.045) and recent memory (r =0.160,P =0.014) scores in CAMCOG-C.The UA level remained associated with MMSE after controlling for age,sex,education,hypertension,diabetes,smoking,and BMI (β =-0.121,P =0.044).While,after adjusting grading of a leukoaraiosis,UA has no significant association with MMSE.Conclusions The bilirubin level is decreased while the UA level is elevated in SIVD patients.The serum TBIL is negatively correlated with cognition dysfunction,while UA is strongly related to cognition dysfunction in SIVD patients.Cognitive dysfunction resulting from UA might have close association with leukoaraiosis.
