Sex-dependent association analysis between serum uric acid and spontaneous hemorrhagic transformation in patients with ischemic stroke

Abstract

ObjectiveThe association between serum uric acid (UA) and spontaneous hemorrhagic transformation (HT) has been seldom studied, and the role of UA in spontaneous HT remains unclear. This study aims to investigate the sex-dependent association between UA and spontaneous HT in patients with ischemic stroke.MethodWe retrospectively included patients with ischemic stroke in a tertiary academic hospital between December 2016 and May 2020. Patients were included if they presented within 24 h after the onset of symptoms and did not receive reperfusion therapy. Spontaneous HT was determined by an independent evaluation of neuroimaging by three trained neurologists who were blinded to clinical data. A univariate analysis was performed to identify factors related to spontaneous HT. Four logistic regression models were established to adjust each factor and assess the association between UA and spontaneous HT.ResultsA total of 769 patients were enrolled (64.6% were male patients and 3.9% had HT). After adjusting the confounders with a P < 0.05 (model A) in the univariate analysis, the ratio of UA and its interquartile range (RUI) was independently associated with spontaneous HT in male patients (OR: 1.85; 95% CI: 1.07–3.19; P = 0.028), but not in female patients (OR: 1.39; 95% CI: 0.28–6.82; P = 0.685). In models B–D, the results remain consistent with model A after the adjustment for other potential confounders.ConclusionsHigher serum UA was independently associated with a higher occurrence of spontaneous HT in male patients who were admitted within 24 h after the stroke onset without receiving reperfusion therapy.

Association Between Uric Acid and Hemorrhagic Transformation: A Systematic Review and Meta-Analysis

“…There are gender differences in UA degrees, and studies have confirmed that the average UA degree is significantly lower in female than in male due to estrogen 3, 46 . A sex-stratified analysis of one study we brought to a close demonstrated that 3 , UA degrees in male were significantly higher than those in female, and the incidence of HT was lower than that in female, which corresponded with earlier discoveries, as anticipated.…”

Lower serum uric acid to serum creatinine ratio as a predictor of poor functional outcome after mechanical thrombectomy in acute ischaemic stroke

“…Our research suggested that a lower SUA/SCr ratio indicated a likelihood of poor functional outcome in AIS patients who underwent MT. Although prior research has suggested a link between higher SUA levels and spontaneous haemorrhagic transformation [40] and some studies reported the link between SUA and haemorrhagic transformation or sICH in AIS patients after reperfusion therapy [41,42], there has been no research investigating the relationship between SUA/SCr ratio and symptomatic haemorrhage. Our study observed no association between SUA/SCr ratio and sICH in patients undergoing MT.…”