Association between serum uric acid and carotid disease in patients with atherosclerotic acute ischemic stroke

Abstract

Aim The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease. Methods Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis. Results A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 -1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005). Conclusion Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.

Meta-analysis of the correlation between serum uric acid level and carotid intima-media thickness

“…Carotid intima-media thickness is associated with the degree of coronary atherosclerosis and the outcome of ischaemic stroke and has been used as an alternative marker for cardiovascular and cerebrovascular diseases in clinical trials and observational studies [34][35][36][37]. The…”

“…Duplicate publications, lectures and review articles (n = 58), as well as articles that were not relevant to the subject and did not meet the inclusion criteria (n = 256), were excluded. The remaining 139 studies were screened after reading the full text, and 15 studies were included in the meta-analysis [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. The specific process is shown in Fig 1.…”

Association Between Serum Uric Acid Levels and Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis of Observational Studies

“…As a result, serum uric acid levels can rise if uric acid production is excessive and/or if uric acid is cleared too slowly. In addition, some work suggests that increased serum uric acid level might be an independent risk factor for hypertension (21), cardiovascular events (22), metabolic syndrome (23), ischemic stroke (24), as well as BPPV (6).…”

Study of association of serum uric acid with albuminuria and carotid atherosclerosis in type 2 diabetes mellitus patients

“…Also José Carlos Arévalo-Lorido et al . [20] in a study concluded that the effects of UA on the vascular wall contribute to the development of atherosclerosis and carotid disease. Similar relation between UA and atherosclesoris was found in various studies.…”