Cerebral macro- and micro-structural impairment are neuroradiological mediators for serum uric acid variance-related cognitive decline

Motivation: The longitudinal effects of changes in serum uric acid (SUA) levels on brain health are largely unknown. Goal(s): This study aimed to evaluate the longitudinal associations of SUA variance with neuroimaging indices and cognitive function. Approach: The multivariate-adjusted associations of SUA variance with brain MRI markers and cognitive function were examined using generalized linear models and logistic regression models. Mediation analyses were performed to assess whether brain MRI markers mediate the relationship between SUA variance and cognitive function. Results: Changes in SUA concentration, particularly elevated SUA levels damages brain health, manifested as smaller brain tissue volume, impaired microstructural integrity, and poorer cognitive performance. Impact: In conclusion, our study findings deepen the comprehension of an integrated relationship between SUA variance and neuroimaging indices of brain health. Long-term prevention of SUA fluctuation is essential for protecting brain health and preventing early-stage dementia.