Sex‐Specific Relationship Between Serum Uric Acid and Risk of Stroke: A Dose‐Response Meta‐Analysis of Prospective Studies

Abstract

BackgroundConflicting findings of the association between serum uric acid (UA) and stroke have been reported in both men and women, and it is unclear whether this association was different between men and women. We preformed this meta‐analysis to assess the sex‐specific effect of serum UA on the risk of stroke and its subtypes.Methods and ResultsProspective studies that reported sex‐specific association of UA levels with stroke or reported in a certain sex were included. Dose‐response relationships were assessed by the generalized least squares trend estimation, and summary effect estimates were evaluated with random‐effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Altogether, 13 prospective studies were identified in this study. The summary of relative risks (95% CIs) of stroke for a 1‐mg/dL increase in serum UA levels were 1.10 (1.05–1.14) for men and 1.11 (1.09–1.13) for women. There is no significant difference in the effect of UA on future stroke risk between men and women (P interaction=0.736). Subgroup analyses showed that the significant associations persisted in most stratifications, and sensitivity analyses according to various inclusion criteria yielded similar results. A nonlinear relationship was observed in men (P non‐linearity<0.001), with risk increasing significantly from a UA of 6 mg/dL and more steeply at higher UA levels.ConclusionsElevated serum UA levels were significantly associated with modestly increased risk of stroke in both men and women and have similar adverse effects on development of stroke in both sexes.

The causality between the serum uric acid level and stroke

“…Although Jiaqi et al failed to show that an elevated SUA level is an independent predictor for total and ischemic strokes in men, they showed a J-shaped risk trend in men, which is consistent with the results from a recent meta-analysis ( Fig. 1) [6]. Many reports about the sex and age differences in SUA have been published [12,13].…”

“…Another meta-analysis study by Zhong et al showed similar results: elevated SUA levels were significantly associated with a modestly increased risk of stroke in both men (RR 1.10 per 1 mg/dL increase in SUA) and women (RR 1.11) ( Fig. 1) [6]. There seems to be no doubt about the relationship between SUA and stroke.…”

“…The causality between SUA and gout is well established, but the causality between SUA and stroke is still to be discussed, as well as that for hypertension [3] or chronic kidney disease [4]. Several meta-analysis studies have indicated that the SUA level is "independently" associated with stroke [5,6]. Kim S.Y.…”

“…Moreover, some studies showed that the relationship between the SUA level and stroke risk differed by sex, indicating a nonlinear (J-shaped) relationship in men, whereas an almost linear trend was observed in women ( Fig. 1) [6,10]. The relationship between the SUA level and stroke is well established, but the causality remains controversial because robust evidence has not been adequately accumulated.…”

Microneedle array sensors based on carbon nanoparticle composites: interfacial chemistry and electroanalytical properties

“…The electroanalytical performance of the MN system was evaluated through examining the response to uric acid. The latter is a common biomarker in a range of clinical conditions, such as hypertension [22], kidney function [23], stroke [24] and cardiovascular disease [25,26]. It is little surprise therefore that there is an extensive literature base on its electrochemical detection and, with continuing advances in 2D carbon nanomaterials and other catalytic particles, continues to hold the interest of the diagnostics [27][28][29][30][31].…”