Objective: Growing evidence suggest that uric acid is a relevant risk factor for arteriolosclerosis and thus it might be associated with cerebral small vessel disease. The aim of our study was to investigate the association of serum uric acid levels to conditions related to cerebral small vessel disease. Design and method: One hundred elderly patients (48 males and 52 females, mean age ± SD of 82.9 ± 6.33 years) referring to our Geriatric Unit for whom CT scans were available were recruited. Clinical and laboratory data were collected, together with CT images. Results: Uric acid levels resulted positively related to severity of leukoaraiosis on CT images, evaluated with the Blennow scale (p = 0.017). Moreover, uric acid was found to be positively associated with the presence (p = 0.0001), number (p = 0.023), size (p = <0.001) and location of lacunar infarcts in basal ganglia (p = 0.003), deep white matter (p = 0.0175) and pons (p = 0.0228). A significant association was also found between uric acid and silent lacunar infarcts (p = 0.0002). Stepwise multiple regression analysis confirmed the association with the presence (p = 0.0001), number (p = 0.0461), size (p = <0.001) and location of lacunar infarcts in basal ganglia (p = 0.003) and pons (p = 0.02), while the association with severity of leukoaraiosis on CT images became marginally non significant (p = 0.09). In subjects with uric acid <356.88 umol/L) only a trend toward a negative association with number (p = 0.16) and size (p = 0.20) of lacunar infarcts became evident. Conclusions: Our study points to a positive association between increased circulating levels of uric acid and lacunar infarcts which is independent of traditional cardiovascular risk factors. These data suggest that serum uric acid could play an influential role on the pathophysiology of cerebral small vessel disease.
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