Association between serum urate and CSF markers of Alzheimer's disease pathology in a population-based sample of 70-year-olds.

Introduction: The relationship between urate and biomarkers for Alzheimer's disease (AD) pathophysiology has not been investigated.

Methods: We examined whether serum concentration of urate was associated with cerebrospinal fluid biomarkers, amyloid beta (Aβ), Aβ, phosphorylated tau (p-tau), total tau (t-tau), neurofilament light (NfL), and Aβ/Aβ ratio, in cognitively unimpaired 70-year-old individuals from Gothenburg, Sweden. We also evaluated whether possible associations were modulated by the apolipoprotein E () ε4 allele.

Results: Serum urate was positively associated with Aβ in males (β = 0.55 pg/mL,  = .04). There was a positive urate- ε4 interaction (1.24 pg/mL,  = .02) in relation to Aβ association. The positive urate and Aβ association strengthened in male ε4 carriers (β = 1.28 pg/mL,  = .01).

Discussion: The positive association between urate and Aβ in cognitively healthy men may suggest a protective effect of urate against deposition of amyloid protein in the brain parenchyma, and in the longer term, maybe against AD dementia.