Association of serum uric acid with early post-stroke cognitive impairment after acute minor ischemic stroke and transient ischemic attack

 'Associations' don't get you recovered, or are you too fucking stupid to see that? What prevents post stroke cognitive impairment is the needed research, not this crapola!

Association of serum uric acid with early post-stroke cognitive impairment after acute minor ischemic stroke and transient ischemic attack

• Dongyao Fan,
• Panpan Zhao,
• Lin Shi,
• Meng Zhao,
• ChunXiao Wei &
• Li Sun 

Scientific Reports (2026) Cite this article

Abstract

Serum uric acid (SUA) is associated with cognitive impairment, but relevant studies are controversial, and studies on SUA and cognitive impairment after acute minor ischemic stroke and transient ischemic attack (TIA) are scarce. This exploratory study included 543 patients with mild ischemic stroke and TIA who were admitted to the First Hospital of Jilin University from April 2019 to March 2022. Demographic, imaging, hematological data and comprehensive cognitive scale assessment were collected. Early Post-Stroke cognitive impairment was defined as a Montreal Cognitive Assessment score < 22 points, assessed at 7–10 days after acute minor ischemic stroke or TIA. The association between SUA and early PSCI was assessed using multivariable logistic regression, adjusting for both clinically relevant variables and those significant in univariate analysis. Sensitivity analysis was performed by excluding the 5 participants with the highest serum SUA values. A restricted cubic spline was employed to evaluate potential nonlinear relationships, followed by segmented regression and stratified analysis by age (< 65 years) and sex. SUA showed a nonlinear association with early PSCI, with the lowest estimated risk observed at approximately 409 µmol/L. For every 1 µmol/L increase between 256.87 and 408.99 µmol/L, the risk of early PSCI decreased by 0.7% (OR 0.993, 95% CI 0.989–0.997, P < 0.001). In cognitive domain analyses, SUA also showed nonlinear associations with memory and executive function. Similar findings were observed after exclusion of extreme high SUA values. The association between SUA and early PSCI was generally consistent across sex and age subgroups. SUA showed a nonlinear association with early cognitive impairment after acute minor ischemic stroke and TIA. These findings are hypothesis-generating and require confirmation in larger longitudinal studies.

Association between uric acid to lymphocyte ratio and poor functional outcomes in acute ischemic stroke patients

 

Why are your predicting failure to recover RATHER THAN DELIVERING RECOVERY?

Laziness? Incompetence? Or just don't care? NO leadership? NO strategy? Not my job? Not my Problem!

You're all fired! Biomarkers  do nothing for recovery unless you are mapping EXACT RECOVERY PROTOCOLS to them!

Association between uric acid to lymphocyte ratio and poor functional outcomes in acute ischemic stroke patients

• 

  Xu Zhu 1†

• 

  Yijun Zhang 2,3,4,5,6†

• G

  Guoyuan Yu 1†

• 

  Anxin Wang 2,3,4,5,6

• X

  Xiaoli Zhang 2,3,4,5,6

• S

  Shifeng Xiang 1

• 

  Xia Meng 2,3,4,5,6*

• Y

  Yiping Wu 1*

• 1. Department of Neurology, Handan Central Hospital, Handan, China

• 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Abstract

Background: 

Inflammation has an important impact on the pathological progression associated with ischemic stroke. Serum uric acid (UA) to lymphocyte ratio (ULR) is a biomarker that responds to the level of inflammation but is not definitively associated with the clinical outcomes in patients with acute ischemic stroke (AIS).

Methods: 

The data were obtained from the Third China National Stroke Registry (CNSR-III). Enrolled AIS patients were grouped by ULR quartiles at admission. The outcomes were poor functional outcomes (modified Rankin Scale [mRS] score of 3–6 or 2–6) and all-cause mortality at 3 months and 1 year. The associations of ULR with the risk of poor functional outcome and all-cause mortality were analyzed by multivariable logistic regression and Cox proportional hazards regression.

Results: 

A total of 8,241 patients were included from the CNSR-III study. After adjusting for confounders, it was found that patients in the highest ULR quartile had higher mRS scores of 2–6 (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.15–1.53) and 3–6 (OR, 1.35; 95% CI, 1.16–1.57) at the 3-month follow-up. Additionally, the highest ULR quartile was associated with an increased risk of all-cause mortality at the 3-month follow-up (hazard ratio [HR], 1.97; 95%CI, 1.22–3.18). Similar results were observed at the 1-year follow-up.

Conclusion: 

Elevated ULR increased the risks of poorer functional outcomes and all-cause mortality in the AIS patients. However, this observational study was limited by potential unmeasured confounders, selection bias, residual confounding, and restricted generalizability to other populations.

Association of serum uric acid to serum creatinine ratio with 1-year stroke outcomes in patients with acute ischemic stroke: A multicenter observational cohort study

 You described a stroke risk factor but provided NOTHING to prevent the risk! Useless. 

Association of serum uric acid to serum creatinine ratio with 1-year stroke outcomes in patients with acute ischemic stroke: A multicenter observational cohort study

Dandan Zhang  ^{1   2} , Zhongzhong Liu  ^{1   2   3} , Weiyan Guo  ² , Qingli Lu  ^{1   2} , Zhen Lei  ⁴ , Pei Liu  ^{1   2} , Tong Liu  ^{1   2} , Linna Peng  ^{1   2} , Qiaoqiao Chang  ^{1   2} , Mi Zhang  ^{1   2} , Xuemei Lin  ^{1   2} , Fang Wang  ^{1   2} , Songdi Wu  ^{1   2   4}

Affiliations

• PMID: 39104135
• PMCID: PMC11555002
• DOI: 10.1111/ene.16431

Abstract

Background and purpose: Considering the reliance of serum uric acid (SUA) levels on renal clearance function, its role in stroke outcomes remains controversial. This study investigated the association of renal function-normalized SUA (SUA to serum creatinine ratio, SUA/SCr), a novel renal function index, with the 1-year outcomes in patients with acute ischemic stroke (AIS).

Methods: This is a prospective, multicenter observational study. Renal function-normalized SUA levels were determined by calculating the ratio of SUA to SCr. One-year outcomes included stroke recurrence, all-cause mortality, and poor prognosis. Multivariable Cox regression analyses and restriction cubic splines for curve fitting were used to evaluate SUA/SCr's association with 1-year stroke outcomes.

Results: Among 2294 enrolled patients, after adjustment for potential confounders, multivariable Cox regression analyses showed that each one-unit increase in SUA/SCr corresponded to a 19% decrease in 1-year stroke recurrence in patients with AIS. SUA/SCr was analyzed as a continuous variable and categorized into quartiles (Q1-Q4). Compared with the Q1 reference group, Q2, Q3, and Q4 showed significantly lower 1-year stroke recurrence risks. The trend test indicated significant differences in the 1-year stroke recurrence trend from Q1 to Q4. In these patients, SUA/SCr did not show a significant association with poor prognosis or all-cause mortality. Curve fitting revealed SUA/SCr had a negative but nonlinear association with 1-year stroke recurrence.

Conclusions: In patients with AIS, low SUA/SCr may be an independent risk factor for 1-year stroke recurrence. Changes in SUA/SCr had no significant impact on 1-year poor prognosis and all-cause mortality.

Keywords: acute ischemic stroke; renal function; serum creatinine; serum uric acid; stroke outcomes.

© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

PubMed Disclaimer     

Serum uric acid as a predictor of mortality in patients with stroke: results from National Health and Nutrition Examination Survey 2007–2016

 Who approved this useless research that predicts mortality rather than prevents it? They need to be fired!

Serum uric acid as a predictor of mortality in patients with stroke: results from National Health and Nutrition Examination Survey 2007–2016

Xinyu Tong¹Chuxin Lyu²Minjie Guo¹Jianxiong Gu¹Yichun Zhao^1*

• ¹Department of Neurology, Wuxi Traditional Chinese Medicine Hospital, Wuxi, China
• ²First Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, China

Objective: This research endeavors to explore the relationship between serum uric acid (SUA) concentration and all-cause mortality in stroke patients.

Methods: We undertook a cross-sectional analysis utilizing data derived from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2016. The concentrations of SUA served as the independent variable, while the dependent variable was defined as all-cause mortality in stroke patients. The quartile method was utilized to classify uric acid levels into four distinct categories. Subsequently, three models were developed, and Cox proportional hazards regression was used to assess the effect of varying uric acid concentrations on the risk of all-cause mortality among stroke patients.

Results: The study included a total of 10,805 participants, of whom 395 were stroke patients. Among all populations, the group with elevated levels of uric acid (Q4) exhibited a significant association with the overall mortality risk among stroke patients in all three models (model 1 p < 0.001, model 2 p < 0.001, model 3 p < 0.001). In the male population, there was no significant correlation observed between uric acid levels and the overall mortality risk among stroke patients in model 3 (Q2 p = 0.8, Q3 p = 0.2, Q4 p = 0.2). However, within the female population, individuals with high uric acid levels (Q4) demonstrated a noteworthy association with the overall mortality risk among stroke patients across all three models (model 1 p < 0.001, model 2 p < 0.001, model 3 p < 0.001).

Conclusion: This cross-sectional investigation reveals a significant correlation between SUA levels and all-cause mortality in stroke patients, with a noticeable trend observed among females. Consequently, SUA may serve as a promising biomarker for assessing the prognosis(Why? So you can tell your patients they are going to DIE!) of individuals affected by stroke.

Introduction

Stroke, a term encompassing sudden localized or diffuse neurological deficits, is attributed to the disturbance of blood circulation. Sometimes stroke is covert. According to the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2017, stroke is ranked as the third leading cause of mortality and disability, quantified by disability-adjusted life years (DALY). Furthermore, it is the second most significant contributor to death and disability (1, 2). In 2017, the global incidence of acute ischemic strokes was approximately 950 per 100,000 individuals (3).

Following a significant long cessation of oxygen supply resulting from blood inflow or outflow disturbance, a sequence of cascading events (4) is initiated, which includes ATP depletion, alterations in sodium, potassium, and calcium ion concentrations, an increase in lactic acid, acidosis, the accumulation of oxygen free radicals, cell edema, and proteolysis. These processes ultimately result in cell death and neurological deficits. Prior research has identified numerous contributing factors to these neurological deficits after a stroke. It has been found that hypertension, suboptimal blood glucose control, smoking, alcohol consumption, and other unhealthy lifestyle habits significantly influence neurological deficits following a stroke (5–9). Serum uric acid (SUA) serves as a prevalent index in serological tests. Its impact on blood pressure and renal function is notable, particularly due to its role in generating oxidative stress via xanthine oxidase. This enzyme binds with endothelial cells, thereby inhibiting the activity of nitric oxide (NO), which results in vascular damage. Inflammation and damage of blood vessels lead to atherosclerosis, thereby promoting the occurrence and development of stroke.

Several prior meta-analyses have demonstrated that hyperuricemia marginally elevates the risk of stroke morbidity and mortality (10, 11). However, contrasting findings suggest the potential beneficial effects of SUA on the central nervous system (12, 13). Reactive oxygen species, induced by ischemia/reperfusion injury, play a significant role in neuronal cell death. Consequently, the antioxidant properties of SUA may be advantageous for neuronal survival. Currently, only a handful of small-scale studies have indicated that a reduction in serum uric acid (SUA) levels is independently linked to adverse outcomes following acute ischemic stroke (14). Therefore, further research is required to substantiate whether SUA levels can effectively influence the prognosis of stroke patients.

However, limited research has been conducted to explore the relationship between SUA levels and all-cause mortality. The optimal range of SUA levels that could prevent death remains ambiguous, necessitating substantial evidence from the general population to fill these knowledge gaps. Consequently, this study will utilize the public NHANES database, which boasts a large sample size. We conducted a cross-sectional study utilizing pooled data from the NHANES spanning 2007 to 2016, aiming to elucidate the specific association between SUA levels and all-cause mortality in patients with stroke.

More at link.