Relationship between Uric Acid Level and Severity of Acute Primary Cerebral Infarction: A Cross-Sectional Study

Abstract

Numerous studies have shown that uric acid (UA) is associated with cerebrovascular disease, but whether UA is a protective factor or worsens the risk of developing cerebrovascular disease remains controversial. This study investigated the relationship between UA levels detected at admission and the severity of acute primary cerebral infarction. This cross-sectional study enrolled patients with acute primary cerebral infarction (N=238, 157 men). We designated the levels of serum UA measured at the time of admission as the independent variable and the degree of neurological impairment at admission as the dependent variable. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the extent of neurological dysfunction: NIHSS≤5, minor stroke; NIHSS>5, moderate to severe stroke. There was a statistically significant difference in UA levels between patients with mild cerebral infarctions (NIHSS≤5) and those with moderate or severe cerebral infarctions (NIHSS>5) (P<0.0001). After adjusting for confounding factors, the serum UA level was found to be nonlinearly related to NIHSS, and the inflection point was 372 μmol/L. The extent of the influence and confidence interval was 0.99 (0.98, 0.99) on the left side of the inflection point and 1.00 (1.00, 1.01) on the right side. There was a nonlinear relationship between the UA level measured on admission and the degree of neurological impairment in patients with acute primary cerebral infarction. When UA was <372 μmol/L, it was negatively correlated with the degree of neurological impairment in patients with acute cerebral infarction, but when UA was ≥372 μmol/L, the protective effect of UA disappeared.

The Prognostic Value of Serum Uric Acid in Hospitalized Patients with Acute Cerebral Infarction

“…These factors on their own might increase the risk of stroke and result in adverse outcomes following stroke. Further, the SUA level was found to be nonlinearly related to the degree of neurological impairment in patients with acute primary cerebral infarction [ 33 ]. When the SUA was <372 μ mol/L, it was negatively correlated with the degree of neurological impairment in patients with ACI.…”

Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study

“…We further explored the nonlinearity between the TG/HDL-c ratio and unfavorable outcomes using generalized additive models (GAM) and smooth curve fitting (penalized splines). If nonlinearity is detected, we first compute the inflection point using a recursive algorithm (The recursive algorithm begins with an arbitrary initiation followed by filtering/smoothing steps to find the inflection point) and then build a two-piece binary logistic regression model on both sides of the inflection point [ 31 ]. A log-likelihood ratio test was used to determine the most appropriate model describing the association of TG/HDL-c ratio and unfavorable outcomes in patients with AIS.…”

Body mass index has a non-linear association with three-month outcomes in men with acute ischemic stroke: An analysis based on data from a prospective cohort study

“…The recursive algorithm starts with a random initialization and then uses a filtering/smoothing step to find the inflection point. We then built a binary logistic regression model on both sides of the inflection point ( 31 ). The log-likelihood ratio test was used to find the best model to describe the link between BMI and unfavorable outcomes in participants with AIS.…”