Role of Increased Serum Uric Acid in Stroke

Abstract

ABSTRACT:The role of hyperuricemia as a risk factor for acute stroke is debatable as it is not clear whether Serum Uric Acid (SUA) promotes or protects against the cerebrovascular disease. In this study, the serum uric acid level and other risk factors like lipid profile, S. Adenosine Deaminase was estimated in patients with acute stroke and their relationship with ischemic stroke, and the association of factors like age, sex, obesity and smoking in the development of ischemic stroke. METHODS: A prospective, randomized study conducted on 100 cases of ischemic stroke presenting to Department of Medicine, GMC, Amritsar. Risk factors for stroke were noted such as hypertension, diabetes mellitus, metabolic syndrome, smoking, and obesity. Serum uric acid levels were measured in cases and controls. In addition the measurement of other risk factors likes lipid profile, Fasting blood sugar and S. Adenosine deaminase was done. The collected data were analyzed using Student's t-test. RESULTS: Out of 100 patients, 69 were males and 31 were females. The hyperuricemia and ischemic stroke was more in males than females (46 vs. 23). Hyperuricemia and ischemic stroke was associated with higher FBS (mg/dl) 122.33±18.46 and 129.37±15.40, HbA1c (mg/dl) 6.87±2.1 and 6.82±6.21, S. Triglyceride (mg/dl) 162.34±14.08 and 154.34±10.12, S. Total Cholesterol (mg/dl) 169±12.10 and 160.09±14.10, S.HDL-C (mg/dl) 42.11±10.17 and 45.16±11.40, S.LDL-C (mg/dl) 119.85±14.07 and 110.42±12.67, S.ADA (U/L) 45.62±7.90 and 49.47±9.57 at admission and at discharge respectively compared to the control. CONCLUSIONS: Hyperuricemia and ischemic stroke was significantly higher in patients with hypertension, Diabetes mellitus, metabolic syndrome, chronic smokers and BMI > 25 kg/m2. So control of these factors should be done to prevent future onset of ischemic stroke. KEYWORDS: Hyperuricemia, Acute ischemic stroke; adenosine deaminase. INTRODUCTION:Stroke is the third commonest cause of death in the world after coronary heart disease and cancer, especially in the elderly. (1,2) The mortality rate of stroke in the acute phase is as high as 20% and it remains higher for several years after the acute event in stroke patients than in the general population. Stroke, both ischemic and hemorrhagic, is a common and devastating disorder and currently one of the leading causes of mortality worldwide. It is an important cause of disability and dementia in adults aged ≥ 65 years and approximately 25% of stroke survivors develop dementia. (2) Several large studies have shown conflicting results regarding the clinical significance of elevated serum uric acid levels in cardiovascular or cerebrovascular diseases. Studies including the NHANES study concluded that uric acid is an independent risk factor for development of cardiovascular and cerebrovascular diseases. (3) The mortality rate of stroke in the acute phase is as high as 20% and it remains higher several years after the event of stroke. (2) Uric acid is the catabolic product of purine metabolism in humans. Uric acid ...