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)(42), Aβ(40), phosphorylated tau (p‐tau), total tau (t‐tau), neurofilament light (NfL), and Aβ(42)/Aβ(40) ratio, in cognitively unimpaired 70‐year‐old individuals from Gothenburg, Sweden. We also evaluated whether possible associations were modulated by the apolipoprotein E (APOE) ε4 allele. RESULTS: Serum urate was positively associated with Aβ(42) in males (β = 0.55 pg/mL, P = .04). There was a positive urate–APOE ε4 interaction (1.24 pg/mL, P (interaction) = .02) in relation to Aβ(42) association. The positive urate and Aβ(42) association strengthened in male APOE ε4 carriers (β = 1.28 pg/mL, P = .01). DISCUSSION: The positive association between urate and Aβ(42) 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.