Role of uric acid as a biomarker of cognitive function in schizophrenia during maintenance period

Relationship between renal function and cognitive impairment in patients with stable schizophrenia: a multicenter cross-sectional study

OBJECTIVE

Clinically stable inpatients with schizophrenia have generalized impairment of cognitive function along with abnormalities in renal function, but the link between cognitive function and renal function has been underexplored.

METHODS

This study enrolled 216 hospitalized patients with clinically stable schizophrenia. Demographic and renal function parameters were collected from electronic medical records. Cognitive function was assessed using the Chinese Brief Cognitive Test (C-BCT). To analyze the correlations between renal function and processing speed, attention, working memory, and executive function in patients hospitalized with clinically stable schizophrenia. Covariate-adjusted linear and multivariate logistic regression models were constructed to determine the relationship between renal function and cognitive function. ROC analysis was used to further investigate the prediction of renal function indices in assessing stable schizophrenia inpatients.

RESULTS

Significant variations in serum Cystatin C (CysC), β2-microglobulin (β2-MG), and uric acid (UA) levels were observed among hospitalized patients with clinically stable schizophrenia across different cognitive impairment severities. Correlation analysis revealed a significant association between serum CysC levels and C-BCT scores in hospitalized patients with stable schizophrenia (β = 0.174, 95%CI:0.265 ~ 1.720, p = 0.008). Particularly strong correlations were observed with processing speed T-scores (β = -0.200, 95%CI: -33.446 ~ -7.230, p = 0.03) and executive function T-scores (β = -0.171, 95%CI: -17.277 ~ -2.082, p = 0.013). Binary logistic regression analysis further confirmed that CysC may be a risk factor for exacerbation of cognitive impairment in stable schizophrenia (OR = 12.741, 95%CI: 1.424 ~ 114.005, p = 0.023). The combined serum CysC, β2-MG, and UA test for cognitive function in stable schizophrenia inpatients had an AUC area of 0.71, with a sensitivity and specificity of 79.5% and 60.5%, respectively, and a predictive value superior to that of an independent diagnosis.

CONCLUSION

In hospitalized patients with stable schizophrenia, serum CysC levels are positively correlated with the severity of cognitive impairment, particularly showing significant associations with information processing speed and executive function. CysC may be a risk factor for exacerbating cognitive impairment in these patients. The combined diagnostic value of serum CysC, β2-MG, and UA demonstrated moderate accuracy in identifying stable schizophrenia cognitive impairment. These data support the potential of CysC as a biomarker of cognitive function in stable schizophrenia.

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study

Purpose

In clinical work, it has been found that the prevalence of hyperuricemia (HUA) is significantly higher in younger patients with psychiatric disorders, but there are few studies in this area. The present study aims to evaluate the prevalence of HUA and the relationship between the HUA and age in hospitalized patients with psychiatric disorders in the real world, and to provide a theoretical basis for clinical staff to pay attention to the metabolic indicators of younger patients and for future related studies.

Methods

This is a cross-sectional evaluation of a cohort of 1761 patients with psychiatric disorders of hospitalized. The categories of disorders designed for study included: Depression, Bipolar disorder, Schizophrenia, Anxiety, Obsessive-Compulsive disorder, Acute and transient psychotic disorder, Dissociative(conversion) disorders, Conduct disorders and Tic disorders. In addition, based on age, the participants are stratified into three groups. The authors used Kruskal-Wallis tests, chi-square tests, and multiple linear logistic regression to verify the relationship between HUA and age among hospitalized patients with psychiatric disorders.

Results

Overall, the estimated prevalence of HUA was 35.4%. The prevalence of HUA was significantly higher in individuals with 17 years and under compared to those with 45 years and above (P < 0.001). After adjusting for confounders, the prevalence of HUA remained higher at 17 years and under than at 45 years and above. Bipolar disorder can lead to an increased prevalence of HUA (P<0.05).

Conclusion

The prevalence of HUA was higher in hospitalized patients with psychiatric disorders, and the prevalence was inversely proportional to age.