U-Shaped Relationship Between Functional Outcome and Serum Uric Acid in Ischemic Stroke
Yimin Yang1, Ying Zhang2, Yanhua Li1
1Department of Intensive Care Unit, First Hospital of Jilin University, Changchun, China.
Summary
Serum uric acid (SUA) levels at admission predict poor functional outcomes in patients with acute ischemic stroke (AIS). Lower SUA levels are associated with a higher risk of unfavorable outcomes, indicating its clinical relevance.
Area of Science:
- Neurology
- Biochemistry
- Clinical Medicine
Background:
- Acute ischemic stroke (AIS) is a leading cause of disability.
- Identifying early predictors of functional outcome is crucial for patient management.
- Serum uric acid (SUA) is a metabolite with potential roles in cerebrovascular disease.
Purpose of the Study:
- To evaluate the association between admission serum uric acid (SUA) levels and functional outcomes in patients with first-ever acute ischemic stroke (AIS).
- To determine the predictive value of SUA for unfavorable functional outcomes within three months post-stroke.
Main Methods:
- Prospective observational study involving 710 consecutive AIS patients across two centers.
- Serum SUA concentrations measured on admission using high-performance liquid chromatography.
- Analysis of SUA, NIH stroke scale (NIHSS), and conventional risk factors for predicting functional outcome (modified Rankin Scale score > 2).
Main Results:
- An unfavorable functional outcome was observed in 30.8% of patients.
- A U-shaped relationship was noted between SUA levels and unfavorable outcomes, with the lowest risk at the 67th percentile (309 µmol/L).
- After adjusting for other predictors, SUA remained an independent predictor of unfavorable outcomes (adjusted OR 0.996; P<0.001).
Conclusions:
- Admission SUA levels are significantly associated with the risk of poor functional outcomes in Chinese patients with AIS.
- The study highlights a U-shaped exposure-risk relationship, suggesting a specific SUA range is associated with the best outcomes.
- SUA measurement at admission offers valuable prognostic information for AIS patients.
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