Uric Acid Contributes to Obesity-Paradox of the Outcome of Ischemic Stroke

Tang, Hefei; Mo, Jinglin; Chen, Zimo; Xu, Jin; Wang, Anxin; Dai, Liye; Cheng, Aichun; Wang, Yongjun

doi:10.3389/fneur.2019.01279

Cited by 10 publications

(10 citation statements)

References 39 publications

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“…Contrary to the previously mentioned relationship between higher uric acid levels and poor outcomes, Tang et al found that lower uric acid levels are associated with poor outcomes [ 15 ]. However, higher uric acid levels have been associated with better stroke outcomes in some studies, and in patients with thrombolysis [ 5 , 16 , 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 89%

“…The neuroprotective antioxidant effect of uric acid has been documented by several studies in which patients with higher levels of uric acid during AIS exhibited a better outcome [ 5 , 6 , 14 , 18 , 19 ], particular in men [ 16 , 17 ], and patients with lower levels of uric acid had worse outcome [ 15 , 40 ]. Similar observation has been reported that patients with multiple sclerosis, neuromyelitis optica, and Parkinson’s disease showed lower uric acid levels when compared with healthy controls [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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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“…Results of prospective cohort studies within the general population consistently show that high BMI increases stroke risk [6][7][8][9]. However, the contradicting results found within the obesity paradox for stroke have been reported in studies with established stroke cohorts [10][11][12][13][14][15][16][33][34][35][36][37]. Several studies have also reported that the strength of correlation between high BMI and low stroke mortality was attenuated by age [10,13].…”

Section: Discussionmentioning

confidence: 96%

“…Reports also suggest that obesity may be protective for CVD severity or outcome [3][4][5]. Though most population-based cohort studies have shown that obesity increases the risk of stroke [6][7][8][9], obesity has been associated with better outcomes among patients with acute ischemic stroke (AIS) [10][11][12][13][14][15][16]. Khan et al evaluated associations between BMI and lifetime CVD risk and mortality among a population-based cohort without established CVD at baseline [17].…”

Section: Introductionmentioning

confidence: 99%

Another Look at Obesity Paradox in Acute Ischemic Stroke: Association Rule Mining

Kim

Lee

et al. 2021

JPM

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Though obesity is generally associated with the development of cardiovascular disease (CVD) risk factors, previous reports have also reported that obesity has a beneficial effect on CVD outcomes. We aimed to verify the existing obesity paradox through binary logistic regression (BLR) and clarify the paradox via association rule mining (ARM). Patients with acute ischemic stroke (AIS) were assessed for their 3-month functional outcome using the modified Rankin Scale (mRS) score. Predictors for poor outcome (mRS 3–6) were analyzed through BLR, and ARM was performed to find out which combination of risk factors was concurrently associated with good outcomes using maximal support, confidence, and lift values. Among 2580 patients with AIS, being obese (OR [odds ratio], 0.78; 95% CI, 0.62–0.99) had beneficial effects on the outcome at 3 months in BLR analysis. In addition, the ARM algorithm showed obese patients with good outcomes were also associated with an age less than 55 years and mild stroke severity. While BLR analysis showed a beneficial effect of obesity on stroke outcome, in ARM analysis, obese patients had a relatively good combination of risk factor profiles compared to normal BMI patients. These results may partially explain the obesity paradox phenomenon in AIS patients.

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“…UA is a physiological end-product of purine metabolism that has strong antioxidant properties. It acts as a water-soluble antioxidant and free radical scavenger in the human body and is related to the prevention and treatment of obesity and stroke ( Tang et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Insight Into the Neuroprotective Effect of Tao-He-Cheng-Qi (THCQ) Decoction on ICH Rats Using Untargeted Metabolomics

et al. 2021

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Tao-He-Cheng-Qi decoction (THCQ) is an effective traditional Chinese medicine used to treat intracerebral hemorrhage (ICH). This study was performed to investigate the possible neuroprotective effect of THCQ decoction on secondary brain damage in rats with intracerebral hemorrhage and to elucidate the potential mechanism based on a metabolomics approach. Sprague-Dawley (SD) rats were randomly divided into five groups: the sham group, collagenase-induced ICH model group, THCQ low-dose (THCQ-L)-treated group, THCQ moderate-dose (THCQ-M)-treated group and THCQ high-dose (THCQ-H)-treated group. Following 3 days of treatment, behavioral changes and histopathological lesions in the brain were estimated. Untargeted metabolomics analysis with multivariate statistics was performed by using ultrahigh-performance liquid chromatography–mass spectrometry (UPLC-Q-Exactive Orbitrap MS). THCQ treatment at two dosages (5.64 and 11.27 g/kg·d) remarkably improved behavior (p < 0.05), brain water content (BMC) and hemorheology (p < 0.05) and improved brain nerve tissue pathology and inflammatory infiltration in ICH rats. Moreover, a metabolomic analysis demonstrated that the serum metabolic profiles of ICH patients were significantly different between the sham group and the ICH-induced model group. Twenty-seven biomarkers were identified that potentially predict the clinical benefits of THCQ decoction. Of these, 4 biomarkers were found to be THCQ-H group-specific, while others were shared between two clusters. These metabolites are mainly involved in amino acid metabolism and glutamate-mediated cell excitotoxicity, lipid metabolism-mediated oxidative stress, and mitochondrial dysfunction caused by energy metabolism disorders. In addition, a correlation analysis showed that the behavioral scores, brain water content and hemorheology were correlated with levels of serum metabolites derived from amino acid and lipid metabolism. In conclusion, the results indicate that THCQ decoction significantly attenuates ICH-induced secondary brain injury, which could be mediated by improving metabolic disorders in cerebral hemorrhage rats.

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Uric Acid Contributes to Obesity-Paradox of the Outcome of Ischemic Stroke

Cited by 10 publications

References 39 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

Another Look at Obesity Paradox in Acute Ischemic Stroke: Association Rule Mining

Metabolic Insight Into the Neuroprotective Effect of Tao-He-Cheng-Qi (THCQ) Decoction on ICH Rats Using Untargeted Metabolomics

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