Low Serum Urate Levels May Be Associated with Depression

A new study observed a correlation between low levels of serum urate and depression in older adults.

“Over the last decade, it has been hypothesized that oxidative stress pathways might also be involved in the pathophysiological mechanism of depression. It has been proposed that high levels of urate are associated with a lower risk of hospitalization due to depression and antidepressant medication use in two independent cohorts,” wrote the study authors. “A recent meta-analysis and meta-regression provided additional evidence on this relationship, in which subjects with major depressive disorder had lower levels of serum urate than healthy controls. However, no association between serum urate concentrations and behavioral and clinical characteristics was found in patients with major affective disorders.”

The present study collected data from the Korea National Health and Nutrition Examination Survey 2016 dataset, including sociodemographic characteristics and physical and mental health conditions of patients. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ)-9. Patients were stratified into three age groups: young adults (aged 19–39 years), middle-aged adults (aged 40–59 years), and older adults (aged 60 years and older).

Serum Urate Linked to Depression in Men and Women

Final analysis included 5,332 patients. Four sex-specific quartiles were used to assess serum urate concentrations: males, ≤ 4.9 (Q1), 5.0–5.7 (Q2), 5.8–6.6 (Q3), and ≥ 6.7 (Q4) mg/dL; females, ≤ 3.7 (Q1), 3.8–4.3 (Q2), 4.4–4.9 (Q3), and ≥ 5.0 (Q4) mg/dL. In older adults, a significant negative linear relationship was observed between serum urate quartiles and PHQ-9 scores (P for trend=0.020 in men and 0.048 in women). In older women, low serum urate levels (Q1 and Q2), compared to high levels (Q3 and Q4) were correlated with the overall burden of depression (odds ratio [OR]=1.78; 95% confidence interval [CI], 1.21 to 2.61), and in older men, clinically relevant depression (OR=3.35; 95% CI, 1.16 to 9.70). These associations persisted even in adjusted analyses.

The results were published in Arthritis Research & Therapy.

“Our findings suggest that low levels of serum urate are associated with a higher prevalence of depression in older adults. Longitudinal studies are needed to examine the potential effects of serum urate on the trajectory of depression over time. This may have clinical implications for mental health,” the researchers concluded.