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Background: Uric acid (UA) is now recognized as a natural antioxidant that has neuroprotective properties. While it has beneficial properties, it may directly induce inflammation and vascular events such as atherosclerosis and stroke. In this study, we examined the relation between serum UA level and the burden of hyperintense signals of the cerebral white matter (WM) on Fluid attenuated inversion recovery (FLAIR) in Alzheimer’s disease (AD). Methods: The participants in this study consisted of 71 healthy controls and 129 patients with AD. To assess WM ischemic changes in AD patients, deep white matter (DWM) and periventricular white matter (PVWM) changes were scored as separately, and then their sums were also rated. UA levels were compared between a control and AD group. By using analysis of covariance, we investigated the difference of UA level depending on the clinical WM rating scale. The correlation between WM changes and UA levels was also analyzed. Results: There was significant difference in UA level between the control and AD group (5.59±1.15 mg/dL vs. 4.67±1.16 mg/dL; p=0.001). However, within AD patients, there were no significant differences in UA levels according to the severity of WM changes (4.57±1.22 mg/dL, 4.74±1.03 mg/dL, 4.37±1.39 mg/dL for DWM scores 1,2,3; p=0.28, 4.58±1.24 mg/dL, 4.56±1.05 mg/dL, 4.91±1.15 mg/dL for PVWM scores 1,2,3; p=0.33 and 4.60±1.20 mg/dL, 4.74±1.06 mg/dL, 4.33±1.40 mg/dL for clinical WM rating scales 1,2,3; p=0.29). There was no correlation between the score of Korean version mini-mental status examination and uric acid. Conclusions: The serum UA was decreased in the AD patients regardless of WM rating scores, compared with healthy controls. However, based on the result that showed no difference according to the severity of WM change, it should be considered several possible explanations. These suggest that there is seldom relationship between UA and the burden of WM in AD, although the oxidative injuries play an important role in the pathogenesis of AD.

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