Effects of uric acid transfer into the brain via the choroid plexus in dementia

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16550
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: Kagawa University
• Principal Investigator: Uemura Naoya 香川大学, 医学部, 助教 (20795124)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 尿酸 / 認知症 / 脈絡叢 / 抗酸化作用 / 神経保護作用 / 術後せん妄

Outline of Final Research Achievements

Our laboratory conducted a retrospective observational study on 2,071 patients admitted to the intensive care unit (ICU) after high-invasive surgery, investigating the relationship between serum uric acid levels and postoperative delirium. After excluding patients with a history of central nervous system diseases, postoperative neurosurgery, multiple surgeries, emergency surgeries, and end-stage renal failure, statistical analysis was performed on 558 patients. Delirium evaluation was conducted using the CAM-ICU, a monitoring tool for delirium in ICU patients. There were 78 patients (approximately 14%) who were CAM-ICU (+). In univariate analyses using t-tests and Mann-Whitney U tests, there were significant differences in age, severity (ASA-PS, APACHE II score), and total intraoperative opioid dose, but propensity score analysis did not identify low serum uric acid levels as a risk factor for postoperative delirium.

Free Research Field

老年医学

Academic Significance and Societal Importance of the Research Achievements

近年、股関節骨折手術を受ける高齢患者において術前血清尿酸値の低下が術後せん妄の危険因子である可能性があると報告された（BMC Anesthesiol 2022 ; 22(1): 282）。また、血清尿酸/クレアチニン比が尿路結石を受ける高齢患者において術後せん妄の独立した危険因子であると報告され（Clin Interv Aging 2023 ; 18: 81-92）、血清尿酸値と術後せん妄の関係が注目されている。尿酸の認知機能への影響の解明することで患者の予後を改善し、認知症、せん妄や他の難治性神経疾患の新たな予防法・治療法開発につながるという創造性がある。