J-shaped relationship between serum uric acid levels and the risk of ischemic stroke in high-risk individuals: A hospital-based observational study

Hu, Gaifeng; Li, Juan; Wang, Quan; Wang, Cui; Wang, Yang; Gong, Tao; Liu, Deping

doi:10.1016/j.clineuro.2020.105906

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…The PIUMA study demonstrated a J-shaped relationship between uric acid and cardiovascular events in both genders [ 11 ]. A J-shaped relationship between uric acid and the risk of ischemic stroke was also observed by Hu et al [ 12 ]. A j-curve relationship between uric acid and risk of cardiometabolic diseases was observed only in women by Kuwabara et al [ 13 ].…”

Section: Discussionsupporting

confidence: 66%

J-Shaped Relationship of Serum Uric Acid with Unfavorable Short-Term Outcomes among Patients with Acute Ischemic Stroke

et al. 2022

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(1) Background: The role of uric acid in stroke outcomes remains inconclusive. (2) Methods: We retrospectively enrolled 3370 patients with acute ischemic stroke. (3) Results: Uric acid level was higher in men than in women. Univariate analyses revealed that the rates of hyperuricemia were higher in all patients and in women for unfavorable outcomes. For death, the hyperuricemia rates were higher in all patients including men and women, and the uric acid levels were also higher in all patients and in women. A J-shaped curve was observed between uric acid and the discharge-modified Rankin Scale score. Patients within Quartiles 1 (<4.1 mg/dL) and 4 (>6.5 mg/dL) of uric acid had higher rates of unfavorable outcomes and death than patients within Quartiles 2 (4.1–5.1 mg/dL) and 3 (5.1–6.2 mg/dL). Multivariable analyses for unfavorable outcomes revealed that Quartile 1 of uric acid was a significant factor in all patients and in men. In men, a significant factor for death was being in Quartile 1 of uric acid. In women, higher levels of uric acid or hyperuricemia (>6.6 mg/dL) were significant factors for death. (4) Conclusions: Lower uric acid levels are a predictor for unfavorable outcomes and death in men, and higher uric acid levels are a predictor for death in women.

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Section: Discussionsupporting

confidence: 66%

J-Shaped Relationship of Serum Uric Acid with Unfavorable Short-Term Outcomes among Patients with Acute Ischemic Stroke

et al. 2022

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“…The risk of ischemic stroke was lowest in patients with intermediate uric acid levels compared with those higher in the bottom and upper quartiles. The results suggested a J-shaped relationship between uric acid levels and the risk of ischemic stroke [23]. The study by Khalil et al showed that elevated uric acid levels were significantly associated with the risk of ischemic stroke.…”

Section: The Association Between Uric Acid Level and Ischemic Strokementioning

confidence: 93%

The Association between Uric Acid Level and Ischemic Stroke

Xu,

Wong,

Rusli

et al. 2024

OBM Neurobiol

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Stroke is the second and third leading cause of death and disability, respectively, all over the world. It seriously affects patients' lives and brings huge burdens to their families. Ischemic stroke accounts for most of the stroke cases. In the absence of any effective treatment, prevention measures through controlling the risk factors for ischemic stroke become crucial. While uric acid has been reported as an essential risk factor for ischemic stroke, researchers hold inconsistent views regarding the specific association between uric acid and ischemic stroke. By summarizing the association between uric acid levels and ischemic stroke, this article can guide researchers to quickly and comprehensively understand the relationship between uric acid and ischemic stroke and develop further studies for its exploration.

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“…Among the 780 patients, 230 (29.49%) had an excellent 90-day outcome, the primary outcome of our study (Table S1). Patients with an excellent outcome were younger (61.89±12.70 vs. 65.45±11.75 years; P<0.001), less likely to have a history of diabetes mellitus (13.91% vs. 26.36%; P<0.001), hypertension (52.61% vs. 61.45%; P=0.022), or prior stroke (13.91% vs. 22.36%; P=0.007), and had a lower baseline NIHSS {12 [8][9][10][11][12][13][14][15][16][17] vs. 16 [12][13][14][15][16][17][18][19][20][21][22]; P<0.001}. Patients with an excellent outcome more likely had intravenous r-tPA (27.83% vs. 17.82%; P=0.002), a higher rate of successful reperfusion (82.17% vs. 74.00%; P=0.014), lower maximum systolic blood pressure (SBP) within 24 hours of EVT (144.16±21.09 vs. 150.53±26.30 mmHg; P<0.001), lower WBC [(9.80±5.13 vs. 11.14±3.73)×10 9 /L; P<0.001], lower fasting blood glucose (6.69±2.44 vs. 8.07±3.13 mmol/L; P<0.001), and a higher level of SUA (320.72±97.59 vs. 305.54±95.37 μmol/L; P=0.049) (Table S1).…”

Section: Association Between Sua Level In Quartiles and The Primary O...mentioning

confidence: 99%

“…While in the process of SUA production, reactive oxygen species are generated, increasing oxidative stress (10) and exerting proinflammatory effects such as the stimulation of some cytokines (11). The benefit of SUA against the risk of stroke and other cardiovascular events is unclear from epidemiological studies (12)(13)(14). Two meta-analyses indicated that hyperuricemia could modestly increase the risk of both stroke and mortality (15,16).…”

Section: Introductionmentioning

confidence: 99%

Increased serum uric acid level is associated with better outcome after endovascular treatment for acute ischemic stroke—a prospective cohort study

Bai¹,

Nie²,

Leng³

et al. 2022

Ann Transl Med

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Background: The role of serum uric acid (SUA) in affecting outcomes after endovascular treatment (EVT) in patients with ischemic stroke remains unclear. This study investigated the association of SUA with outcomes of patients with acute large vessel occlusion (LVO) who had received EVT.Methods: Patients with acute LVO stroke who underwent EVT within 24 hours were enrolled from a prospective, nationwide registry study. Baseline characteristics and SUA level within 24 hours of EVT were collected. The primary outcome was an excellent 90-day functional outcome [modified Rankin Scale (mRS) score 0-1]. Secondary outcomes included a favorable 90-day outcome (mRS score 0-2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality. The SUA level was analyzed in quartiles and as a continuous variable. We investigated the independent association of SUA with the primary outcome using multivariable logistic regression.Results: Among 780 patients (mean age 64 years; 66.28% males), 230 (29.49%) had an excellent 90-day outcome. A higher SUA level was significantly associated with an excellent outcome in univariate logistic regression (P=0.045) and after adjusting for confounders in multivariate analysis [adjusted odds ratio (aOR), 0.998; 95% confidence interval (CI), 0.996-1.000; P=0.018]. Multivariate logistic regression analysis showed patients with SUA level in the fourth quartile had an excellent 90-day outcome (aOR, 0.367; 95% CI, 0.154-0.876; P=0.024). There was no significant association for SUA level with favorable 90-day outcome, sICH, or 90-day mortality (P>0.05).Conclusions: Among patients with acute LVO type of stroke who received EVT, baseline high SUA level may predict a better 90-day functional outcome.

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J-shaped relationship between serum uric acid levels and the risk of ischemic stroke in high-risk individuals: A hospital-based observational study

Cited by 5 publications

References 31 publications

J-Shaped Relationship of Serum Uric Acid with Unfavorable Short-Term Outcomes among Patients with Acute Ischemic Stroke

J-Shaped Relationship of Serum Uric Acid with Unfavorable Short-Term Outcomes among Patients with Acute Ischemic Stroke

The Association between Uric Acid Level and Ischemic Stroke

Increased serum uric acid level is associated with better outcome after endovascular treatment for acute ischemic stroke—a prospective cohort study

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