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Horm Metab Res 2023; 55(07): 493-497
DOI: 10.1055/a-2091-1951
Original Article: Endocrine Care

Serum Uric Acid Levels and Recurrence Rate of Ischemic Stroke: A Meta-Analysis

Min Li
1   Department of Neurology, Affiliated Hospital of Chengde Medical College, Chengde, China
,
Hongmei Wang
1   Department of Neurology, Affiliated Hospital of Chengde Medical College, Chengde, China
,
Yanjun Gao
1   Department of Neurology, Affiliated Hospital of Chengde Medical College, Chengde, China
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Abstract

The role of serum uric acid as a factor in the recurrence of ischemic stroke stays unclear. Several studies have examined the relationship between serum uric acid and recurrence of acute ischemic stroke, with various results. Therefore, we carried out a meta-analysis to have a look at the relationship between serum uric acid levels and the potential danger of stroke recurrence in patients with ischemic stroke. Relevant experiments have been recognized via looking out the electronic databases and conference sessions. This present study included a case-control study of the impact of uric acid on the recurrence of ischemic stroke. After the assessment of eligibility, this meta-analysis included four articles in which 2452 patients with ischemic stroke were tested for their level of serum uric acid. The results obtained from this meta-analysis confirmed that improved uric acid concentrations were extensively and independently related to an accelerated and higher risk of recurrent stroke. The pooled OR (95% CI) was 1.80 (1.47, 2.20) (p<0.001). Overall, this meta-analysis shows a relationship between uric acid concentration and stroke recurrence rate. Furthermore, high uric acid levels could enhance the recurrence rate of ischemic stroke.

Key words

serum uric acid - recurrence rate - ischemic stroke - meta-analysis - cardiovascular disease


Publication History

Received: 06 December 2022

Accepted after revision: 02 May 2023

Article published online:
02 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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  • References

  • 1 GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1459-1544
    CrossrefPubMedGoogle Scholar
  • 2 Tiedt S, Brandmaier S, Kollmeier H. et al. Circulating metabolites differentiate acute ischemic stroke from stroke mimics. Ann Neurol 2020; 88: 736-746
    CrossrefPubMedGoogle Scholar
  • 3 GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 439-458
    CrossrefPubMedGoogle Scholar
  • 4 Stinear CM, Lang CE, Zeiler S. et al. Advances and challenges in stroke rehabilitation. Lancet Neurol 2020; 19: 348-360
    CrossrefPubMedGoogle Scholar
  • 5 Herpich F, Rincon F. Management of acute ischemic stroke. Crit Care Med 2020; 48: 1654-1663
    CrossrefPubMedGoogle Scholar
  • 6 GBD 2016 Lifetime Risk of Stroke Collaborators. Feigin VL, Nguyen G. et al. Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016. N Engl J Med 2018; 379: 2429-2437
    CrossrefPubMedGoogle Scholar
  • 7 Wang M, Wang L, Pu L. et al. LncRNAs related key pathways and genes in ischemic stroke by weighted gene co-expression network analysis (WGCNA). Genomics 2020; 112: 2302-2308
    CrossrefPubMedGoogle Scholar
  • 8 Tu WJ, Hua Y, Yan F. et al. Prevalence of stroke in China, 2013–2019: a population-based study. Lancet Reg Health West Pac 2022; 28: 100550
    CrossrefPubMedGoogle Scholar
  • 9 Su XT, Wang L, Ma SM. et al. Mechanisms of acupuncture in the regulation of oxidative stress in treating ischemic stroke. Oxid Med Cell Longev 2020; DOI: 10.1155/2020/7875396.
    CrossrefPubMedGoogle Scholar
  • 10 Li R, Huang C, Chen J. et al. The role of uric acid as a potential neuroprotectant in acute ischemic stroke: a review of literature. Neurol Sci 2015; 36: 1097-1103
    CrossrefPubMedGoogle Scholar
  • 11 Weir CJ, Muir SW, Walters MR. et al. Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke 2003; 34: 1951-1956
    CrossrefPubMedGoogle Scholar
  • 12 Kim SY, Guevara JP, Kim KM. et al. Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum 2009; 61: 885-892
    CrossrefPubMedGoogle Scholar
  • 13 Alderman M, Aiyer KJV. Uric acid: role in cardiovascular disease and effects of losartan. Curr Med Res Opin 2004; 20: 369-379
    CrossrefPubMedGoogle Scholar
  • 14 Wang Z, Lin Y, Liu Y. et al. Serum uric acid levels and outcomes after acute ischemic stroke. Mol Neurobiol 2016; 53: 1753-1759
    CrossrefPubMedGoogle Scholar
  • 15 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-269
    CrossrefPubMedGoogle Scholar
  • 16 Egger M, Davey Smith G, Schneider M. et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634
    CrossrefPubMedGoogle Scholar
  • 17 Akbar HM, Farhad I, Shafa MA. et al. Serum uric acid as an independent predictor of recurrence in ischemic stroke patients. Int Clin Neurosci J 2015; 2: 101-104
    PubMedGoogle Scholar
  • 18 Newman EJ, Rahman FS, Lees KR. et al. Elevated serum urate concentration independently predicts poor outcome following stroke in patients with diabetes. Diabetes Metab Res Rev 2006; 22: 79-82
    CrossrefPubMedGoogle Scholar
  • 19 Wu H, Jia Q, Liu G. et al. Decreased uric acid levels correlate with poor outcomes in acute ischemic stroke patients, but not in cerebral hemorrhage patients. J Stroke Cerebrovasc Dis 2014; 23: 469-475
    CrossrefPubMedGoogle Scholar
  • 20 Ng G, Mei YN. The EZ et al. Abstract TP408: Uric acid and the risk of recurrent vascular events and mortality in ischemic stroke patients: a 5-year analysis. Stroke 2018; 49: ATP408
    PubMedGoogle Scholar
  • 21 Huang J, Hu D, Wang Y. et al. Dose-response relationship of serum uric acid levels with risk of stroke mortality. Atherosclerosis 2014; 234: 1-3
    CrossrefPubMedGoogle Scholar
  • 22 Mayer FJ, Mannhalter C, Minar E. et al. The impact of uric acid on long-term mortality in patients with asymptomatic carotid atherosclerotic disease. J Stroke Cerebrovasc Dis 2015; 24: 354-361
    CrossrefPubMedGoogle Scholar
  • 23 Mohsin M, Das SN, Haque MF. et al. Serum uric acid level among acute stroke patients. Mymensingh Med J 2016; 25: 215-220
    PubMedGoogle Scholar
  • 24 Norvik JV, Schirmer H, Ytrehus K. et al. Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø study 1994-2013.. ESC Heart Fail 2017; 4: 154-161
    CrossrefPubMedGoogle Scholar
  • 25 Anand NN, Padma V, Prasad A. et al. Serum uric acid in new and recent onset primary hypertension. J Pharm Bioallied Sci 2015; 7: S4-S8
    CrossrefPubMedGoogle Scholar
  • 26 De Lucchi L, Nardin C, Sponchiado A. et al. Serum uric acid levels and the risk of recurrent venous thromboembolism. J Thromb Haemost 2021; 19: 194-201
    CrossrefPubMedGoogle Scholar
  • 27 Němec P. Gout and cardiovascular risk. Vnitr Lek 2014; 60: 893-901
    PubMedGoogle Scholar
  • 28 Amaro S, Urra X, Gómez-Choco M. et al. Uric acid levels are relevant in patients with stroke treated with thrombolysis. Stroke 2011; 42: S28-S32
    CrossrefPubMedGoogle Scholar
  • 29 Kang DH, Park SK, Lee IK. et al. Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005; 16: 3553-3562
    CrossrefPubMedGoogle Scholar
  • 30 Chamorro A, Amaro S, Castellanos M. et al. Safety and efficacy of uric acid in patients with acute stroke (URICO-ICTUS): a randomised, double-blind phase 2b/3 trial. Lancet Neurol 2014; 13: 453-460
    CrossrefPubMedGoogle Scholar
  • 31 Kanellis J, Watanabe S, Li JH. et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003; 41: 1287-1293
    CrossrefPubMedGoogle Scholar