{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:30:01Z","timestamp":1785407401695,"version":"3.56.0"},"reference-count":70,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taitung MacKay Memorial Hospital","award":["TTMMH-110-08"],"award-info":[{"award-number":["TTMMH-110-08"]}]},{"award":["TTMMH-110-08"],"award-info":[{"award-number":["TTMMH-110-08"]}],"id":[{"id":"https:\/\/ror.org\/015b6az38","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National Science and Technology Council","award":["112-2320-B-039-008"],"award-info":[{"award-number":["112-2320-B-039-008"]}]},{"award":["112-2320-B-039-008"],"award-info":[{"award-number":["112-2320-B-039-008"]}],"id":[{"id":"https:\/\/ror.org\/02kv4zf79","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU112-N-19"],"award-info":[{"award-number":["CMU112-N-19"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]},{"award":["CMU112-N-19"],"award-info":[{"award-number":["CMU112-N-19"]}],"id":[{"id":"https:\/\/ror.org\/00v408z34","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"crossref","award":["DMR-115-134"],"award-info":[{"award-number":["DMR-115-134"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"crossref"}]},{"award":["DMR-115-134"],"award-info":[{"award-number":["DMR-115-134"]}],"id":[{"id":"https:\/\/ror.org\/0368s4g32","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Hyperuricemia may influence cognitive function, but current evidence remains inconsistent. This study examined the association between hyperuricemia\/gout and cognitive impairment through a prospective cohort study and a systematic review of cohort studies. Methods: Data from 1959 Taiwan Biobank participants aged \u226560 years without mild cognitive impairment (MCI) or dementia at baseline were analyzed over a mean follow-up duration of 4.47 years (2012\u20132021). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Participants were classified by changes in serum uric acid status from baseline to follow-up, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). For the systematic review, cohort studies published up to March 2026 were identified from eight databases. Results: During follow-up, 1013 participants developed incident MCI and 132 developed dementia. Compared with participants who maintained normal serum uric acid levels, those who developed hyperuricemia during follow-up had a significantly lower MCI risk (HR = 0.72, 95% CI = 0.57\u20130.90), as did those with persistent hyperuricemia (HR = 0.78, 95% CI = 0.64\u20130.95). No significant association was observed for dementia. The systematic review of five prospective cohort studies comprising 2,261,704 participants showed inconsistent findings with considerable heterogeneity (I2 = 96.7%). Conclusions: Rising serum uric acid levels were associated with lower MCI risk, but not dementia. These findings should not be interpreted as support for intentionally increasing serum uric acid levels or withholding urate-lowering therapy. Further long-term studies are needed.<\/jats:p>","DOI":"10.3390\/nu18111813","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:52:30Z","timestamp":1780573950000},"page":"1813","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Hyperuricemia on Cognitive Impairment: A Cohort Study and Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9831-5437","authenticated-orcid":false,"given":"Ruei-Ting","family":"Su","sequence":"first","affiliation":[{"name":"Department of Nutrition, Taitung MacKay Memorial Hospital, Taitung City 950, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-144X","authenticated-orcid":false,"given":"Jerry Cheng-Yen","family":"Lai","sequence":"additional","affiliation":[{"name":"Master Program in Biomedicine, College of Science and Engineering, National Taitung University, Taitung City 950, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5553-1496","authenticated-orcid":false,"given":"Pei-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nutrition, China Medical University, No. 100, Section 1, Jingmao Road, Beitun District, Taichung City 406040, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"ref_1","unstructured":"GBD 2019 Dementia Forecasting Collaborators (2022). Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: An analysis for the global burden of disease study 2019. Lancet Public Health, 7, e105\u2013e125."},{"key":"ref_2","unstructured":"World Health Organization (2022, February 01). Dementia. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dementia."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1016\/S0140-6736(17)31363-6","article-title":"Dementia prevention, intervention, and care","volume":"390","author":"Livingston","year":"2017","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2865","DOI":"10.1002\/alz.12901","article-title":"The worldwide costs of dementia in 2019","volume":"19","author":"Wimo","year":"2023","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8999","DOI":"10.1038\/s41598-021-88631-8","article-title":"Possible burden of hyperuricaemia on mortality in a community-based population: A large-scale cohort study","volume":"11","author":"Otaki","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_6","unstructured":"National Institute for Health and Care Excellence (NICE) (2022, July 05). Gout: Diagnosis and Management (NICE Guideline NG219). Available online: https:\/\/www.nice.org.uk\/guidance\/ng219."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Chen, S., Yuan, M., Xu, Y., and Xu, H. (2022). Gout and diet: A comprehensive review of mechanisms and management. Nutrients, 14.","DOI":"10.3390\/nu14173525"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mijailovic, N.R., Vesic, K., and Borovcanin, M.M. (2022). The influence of serum uric acid on the brain and cognitive dysfunction. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.828476"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e041680","DOI":"10.1136\/bmjopen-2020-041680","article-title":"Risk of dementia in gout and hyperuricaemia: A meta-analysis of cohort studies","volume":"11","author":"Pan","year":"2021","journal-title":"BMJ Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104996","DOI":"10.1016\/j.archger.2023.104996","article-title":"Association between gout at midlife and cognitive impairment at late life\u2014The Singapore Chinese Health Study","volume":"111","author":"Tan","year":"2023","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e3207","DOI":"10.1002\/brb3.3207","article-title":"Gout\/hyperuricemia reduces the risk of Alzheimer\u2019s disease: A meta-analysis based on latest evidence","volume":"13","author":"Wang","year":"2023","journal-title":"Brain Behav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"glaf174","DOI":"10.1093\/gerona\/glaf174","article-title":"Association between higher serum uric acid levels and cognitive function: A systematic review and meta-analysis","volume":"80","author":"Rabbani","year":"2025","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.xgen.2022.100197","article-title":"Taiwan Biobank: A rich biomedical research database of the Taiwanese population","volume":"2","author":"Feng","year":"2022","journal-title":"Cell Genom."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2217\/14622416.9.2.235","article-title":"Taiwan Biobank: A project aiming to aid Taiwan\u2019s transition into a biomedical island","volume":"9","author":"Fan","year":"2008","journal-title":"Pharmacogenomics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2188\/jea.JE20240110","article-title":"Validation of self-reported medical condition in the Taiwan Biobank","volume":"35","author":"Wu","year":"2025","journal-title":"J. Epidemiol."},{"key":"ref_16","first-page":"1295","article-title":"Is it time to revise the normal range of serum uric acid levels?","volume":"18","author":"Desideri","year":"2014","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1001\/jama.283.18.2404","article-title":"Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971\u20131992. National Health and Nutrition Examination Survey","volume":"283","author":"Fang","year":"2000","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.apnu.2016.01.015","article-title":"Comparing the sensitivity, specificity, and predictive values of the Montreal Cognitive Assessment and Mini-Mental State Examination when screening people for mild cognitive impairment and dementia in Chinese population","volume":"30","author":"Tsai","year":"2016","journal-title":"Arch. Psychiatr. Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"487","DOI":"10.3233\/JAD-160119","article-title":"Mini-Mental State Examination in elderly Chinese: A population-based normative study","volume":"53","author":"Li","year":"2016","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"v2","DOI":"10.1136\/jnnp.2005.082867","article-title":"Epidemiology and risk factors of dementia","volume":"76","author":"Scheltens","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.psc.2022.07.011","article-title":"Epidemiology and risk factors for dementia","volume":"45","author":"Dintica","year":"2022","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_23","unstructured":"Hayes, A.F. (2022). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, Guilford Press. [3rd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dimache, A.M., \u0218alaru, D.L., Sasc\u0103u, R., and St\u0103tescu, C. (2021). The role of high triglycerides level in predicting cognitive impairment: A review of current evidence. Nutrients, 13.","DOI":"10.3390\/nu13062118"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5011","DOI":"10.1038\/s41598-025-89374-6","article-title":"Association between glycated hemoglobin A1c levels, control status, and cognitive function in type 2 diabetes: A prospective cohort study","volume":"15","author":"Xiao","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1212\/WNL.0b013e3181b38969","article-title":"Association of higher diastolic blood pressure levels with cognitive impairment","volume":"73","author":"Tsivgoulis","year":"2009","journal-title":"Neurology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1046\/j.1532-5415.2002.50122.x","article-title":"The GPCOG: A new screening test for dementia designed for general practice","volume":"50","author":"Brodaty","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_29","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2000). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses, Ottawa Hospital Research Institute. Available online: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s13075-015-0642-1","article-title":"Gout and the risk of dementia: A nationwide population-based cohort study","volume":"17","author":"Hong","year":"2015","journal-title":"Arthritis Res. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1136\/annrheumdis-2014-206917","article-title":"Gout and the risk of Alzheimer\u2019s disease: A population-based, BMI-matched cohort study","volume":"75","author":"Lu","year":"2016","journal-title":"Ann. Rheum. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Singh, J.A., and Cleveland, J.D. (2018). Gout and dementia in the elderly: A cohort study of Medicare claims. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0975-0"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3696","DOI":"10.1038\/s41598-023-30379-4","article-title":"Longitudinal follow-up study of the association with gout and Alzheimer\u2019s disease and Parkinson\u2019s disease in Korea","volume":"13","author":"Lee","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"502","DOI":"10.2188\/jea.JE20200602","article-title":"Rural-urban disparities in the prevalence of mild cognitive impairment and dementia in Taiwan: A door-to-door nationwide study","volume":"32","author":"Liu","year":"2022","journal-title":"J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e661","DOI":"10.1016\/S2468-2667(20)30185-7","article-title":"Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: A cross-sectional study","volume":"5","author":"Jia","year":"2020","journal-title":"Lancet Public Health"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sun, Y., Lee, H.J., Yang, S.C., Chen, T.F., Lin, K.N., Lin, C.C., Wang, P.N., Tang, L.Y., and Chiu, M.J. (2014). A nationwide survey of mild cognitive impairment and dementia, including very mild dementia, in Taiwan. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0100303"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Salari, N., Lotfi, F., Abdolmaleki, A., Heidarian, P., Rasoulpoor, S., Fazeli, J., Najafi, H., and Mohammadi, M. (2025). The global prevalence of mild cognitive impairment in geriatric population with emphasis on influential factors: A systematic review and meta-analysis. BMC Geriatr., 25.","DOI":"10.1186\/s12877-025-05967-w"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/joim.13733","article-title":"Increased risk of dementia differs across cardiovascular diseases and types of dementia\u2014Data from a nationwide study","volume":"295","author":"Kauko","year":"2024","journal-title":"J. Intern. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e030780","DOI":"10.1161\/JAHA.123.030780","article-title":"Cardiovascular disease and Alzheimer\u2019s disease: The heart-brain axis","volume":"12","author":"Saeed","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"879","DOI":"10.3233\/JAD-230019","article-title":"Cardiovascular risk management in persons with dementia","volume":"93","author":"Nijskens","year":"2023","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.nbd.2013.07.005","article-title":"Oxidative stress in blood in Alzheimer\u2019s disease and mild cognitive impairment: A meta-analysis","volume":"59","author":"Schrag","year":"2013","journal-title":"Neurobiol. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Liu, M., Wang, J., Zeng, J., and He, Y. (2017). Relationship between serum uric acid level and mild cognitive impairment in Chinese community elderly. BMC Neurol., 17.","DOI":"10.1186\/s12883-017-0929-8"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e8502","DOI":"10.1097\/MD.0000000000008502","article-title":"The significance of uric acid in the diagnosis and treatment of Parkinson disease: An updated systemic review","volume":"96","author":"Yu","year":"2017","journal-title":"Medicine"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Chen, C., Li, X., Lv, Y., Yin, Z., Zhao, F., Liu, Y., Gao, X., Shi, X., and Zeng, Y. (2021). High blood uric acid is associated with reduced risks of mild cognitive impairment among older adults in China: A 9-year prospective cohort study. Front. Aging Neurosci., 13.","DOI":"10.3389\/fnagi.2021.747686"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Wang, J., Jin, R., Wu, Z., Liu, Y., Jin, X., Han, Z., Chen, H., Lu, X., Xu, K., and Yin, X. (2022). Moderate increase of serum uric acid within a normal range is associated with improved cognitive function in a non-normotensive population: A nationally representative cohort study. Front. Aging Neurosci., 14.","DOI":"10.3389\/fnagi.2022.944341"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1017\/S1092852918001347","article-title":"State of the science on mild cognitive impairment (MCI)","volume":"24","author":"Anderson","year":"2019","journal-title":"CNS Spectr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1111\/imj.13099","article-title":"Young onset dementia","volume":"46","author":"Draper","year":"2016","journal-title":"Intern. Med. J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s11357-016-9871-8","article-title":"Serum uric acid level and association with cognitive impairment and dementia: Systematic review and meta-analysis","volume":"38","author":"Khan","year":"2016","journal-title":"Age"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Liu, Q., Peng, M., Yang, T., and Si, G. (2023). Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0293832"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"116932","DOI":"10.1016\/j.lfs.2019.116932","article-title":"Pathogenetic pathways of cognitive dysfunction and dementia in metabolic syndrome","volume":"237","author":"Borshchev","year":"2019","journal-title":"Life Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7603\/s40681-015-0001-1","article-title":"Emerging roles of frailty and inflammaging in risk assessment of age-related chronic diseases in older adults: The intersection between aging biology and personalized medicine","volume":"5","author":"Wu","year":"2015","journal-title":"Biomedicine"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1080\/15257770802138558","article-title":"Uric acid: The oxidant-antioxidant paradox","volume":"27","author":"Sautin","year":"2008","journal-title":"Nucleosides Nucleotides Nucleic Acids"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1042\/bj2350747","article-title":"Uric acid-iron ion complexes. A new aspect of the antioxidant functions of uric acid","volume":"235","author":"Davies","year":"1986","journal-title":"Biochem. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1006\/abbi.1999.1491","article-title":"Uric acid oxidation by peroxynitrite: Multiple reactions, free radical formation, and amplification of lipid oxidation","volume":"372","author":"Santos","year":"1999","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1136\/hrt.2003.016121","article-title":"Hyperuricaemia does not impair cardiovascular function in healthy adults","volume":"90","author":"Waring","year":"2004","journal-title":"Heart"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.3233\/JAD-2010-1330","article-title":"Uric acid as a CNS antioxidant","volume":"19","author":"Bowman","year":"2010","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kimura, Y., Tsukui, D., and Kono, H. (2021). Uric acid in inflammation and the pathogenesis of atherosclerosis. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222212394"},{"key":"ref_58","first-page":"925","article-title":"Gout and hyperuricemia","volume":"59","author":"Harris","year":"1999","journal-title":"Am. Fam. Physician"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Timsans, J., Palom\u00e4ki, A., and Kauppi, M. (2024). Gout and hyperuricemia: A narrative review of their comorbidities and clinical implications. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247616"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1111\/ene.12969","article-title":"Does serum uric acid act as a modulator of cerebrospinal fluid Alzheimer\u2019s disease biomarker related cognitive decline?","volume":"23","author":"Ye","year":"2016","journal-title":"Eur. J. Neurol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1016\/S0735-1097(01)01643-6","article-title":"Uric acid is closely linked to vascular nitric oxide activity. Evidence for mechanism of association with cardiovascular disease","volume":"38","author":"Maxwell","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1111\/j.1523-1755.2005.00273.x","article-title":"Hyperuricemia induces endothelial dysfunction","volume":"67","author":"Khosla","year":"2005","journal-title":"Kidney Int."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.jjcc.2012.01.013","article-title":"Relationships among hyperuricemia, endothelial dysfunction and cardiovascular disease: Molecular mechanisms and clinical implications","volume":"59","author":"Puddu","year":"2012","journal-title":"J. Cardiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.ijcard.2018.06.017","article-title":"Cross-sectional and longitudinal associations between serum uric acid and endothelial function in subjects with treated hypertension","volume":"272","author":"Tanaka","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Tana, C., Ticinesi, A., Prati, B., Nouvenne, A., and Meschi, T. (2018). Uric acid and cognitive function in older individuals. Nutrients, 10.","DOI":"10.3390\/nu10080975"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/psyg.12053","article-title":"The natural history of dementia","volume":"14","author":"Kua","year":"2014","journal-title":"Psychogeriatrics"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/art.22474","article-title":"Validity of gout diagnoses in administrative data","volume":"57","author":"Harrold","year":"2007","journal-title":"Arthritis Care Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.3899\/jrheum.081195","article-title":"Poor validation of medical record ICD-9 diagnoses of gout in a veterans affairs database","volume":"36","author":"Malik","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1161\/CIRCULATIONAHA.117.029652","article-title":"Socioeconomic status and cardiovascular outcomes: Challenges and interventions","volume":"137","author":"Schultz","year":"2018","journal-title":"Circulation"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Li, M., Nie, Q., Xia, Q., and Jiang, Z. (2025). Assessing cross-national inequalities and predictive trends in gout burden: A global perspective (1990\u20132021). Front. Med., 12.","DOI":"10.3389\/fmed.2025.1527716"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1813\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:51:16Z","timestamp":1780721476000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":70,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["nu18111813"],"URL":"https:\/\/doi.org\/10.3390\/nu18111813","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}