EPV1291 - Low Serum Uric Acid Levels and Risk of Psychiatric Disorders: A Population-Based Cohort Study
EPV1291
Low Serum Uric Acid Levels and Risk of Psychiatric Disorders: A Population-Based Cohort Study
R. Leiba 1,*, O. Lencovsky 2, A. Leiba 2, A. Israel 3
1Unicamillus Medical University, Rome, Italy, 2Nephrology and Hypertension , Assuta Ashdod Hospital, Ashdod, 3Leumit Research Institute, Leumit Health Services , Tel Aviv, Israel
Introduction: Uric acid (UA) is the end product of purine metabolism and a major plasma antioxidant. While elevated UA is linked to metabolic and vascular risk, low UA may diminish neuroprotection and increase vulnerability to oxidative stress.
Objectives: To assess whether low serum UA levels are associated with a higher incidence of psychiatric and neurocognitive disorders in adults.
Methods: A retrospective cohort study was conducted using electronic health records from Leumit Health Services (HMO) (2002–2024). Adults with ≥1 UA measurement were included. Examinees with elevated uric acid ( >6mg/dl for women, >7mg/dL for men) were excluded. Low UA was defined as <3 mg/dL; others served as controls. Exclusion criteria: malignancy, pregnancy, and insulin use. Any low UA level (even on a single occasion) would commit the examinee to the “low urate” group. Only incident (“New”) diagnoses were analyzed to reflect new-onset psychiatric morbidity during follow-up. Analyses used multivariate logistic regression adjusted for age, sex, socioeconomic status, and comorbidities. Mean follow-up: 3367 ± 578 days (≈9.2 ± 1.6 years).
Results: Among 51,348 participants (25,672 low-UA; 25,676 controls; mean age ≈ 51 years), low UA was associated with significantly higher odds of several psychiatric outcomes (Table 1).
Table 1. Incidence and adjusted odds ratios for new psychiatric diagnoses
Diagnosis |
Low UA n (%) |
Normal UA n (%) |
OR (95% CI) |
p |
|
Depression |
593 (2.31) |
427 (1.66) |
1.40 (1.23–1.59) |
<0.001 |
|
Anxiety |
3,845 (15.0) |
3,384 (13.2) |
1.16 (1.10–1.22) |
<0.001 |
|
PTSD |
271 (1.06) |
214 (0.83) |
1.27 (1.06–1.53) |
0.009 |
|
Schizophrenia |
175 (0.68) |
93 (0.36) |
1.89 (1.46–2.46) |
<0.001 |
|
Personality disorder |
292 (1.14) |
185 (0.72) |
1.59 (1.31–1.92) |
<0.001 |
|
Cognitive disorder |
170 (0.66) |
120 (0.47) |
1.42 (1.12–1.81) |
0.003 |
|
Dementia |
234 (0.91) |
149 (0.58) |
1.58 (1.28–1.95) |
<0.001 |
|
Epilepsy |
120 (0.47) |
60 (0.23) |
2.00 (1.46–2.78) |
<0.001 |
|
Headache |
5,013 (19.5) |
4,344 (16.9) |
1.19 (1.14–1.25) |
<0.001 |
Conclusions: Low serum UA levels are independently associated with an increased risk of depression, anxiety, and other psychiatric and neurocognitive disorders. UA may serve as a biomarker of reduced antioxidant defense and heightened neuropsychiatric vulnerability. Prospective and interventional studies should evaluate whether UA-modulating strategies can aid in mental-health prevention or treatment.
Disclosure of Interest: None Declared