Serum uric acid and prognosis in acute ischemic stroke: a dose–response meta-analysis of cohort studies

Frontiers in Aging Neuroscience

Aging Neuroscience

Zhenxiang Zhan¹  Zicheng Cheng¹  Wenyuan Zhang²  Fangwang Fu³ 

[1] Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China;Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, China;Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China;

关键词: acute ischemic stroke;    dose–response meta-analysis;    functional outcome;    prognosis;    uric acid;   

DOI  :  10.3389/fnagi.2023.1223015

 received in 2023-05-15, accepted in 2023-08-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThere have been contradictory findings regarding the relationship between serum uric acid levels and prognosis in acute ischemic stroke. Whether this association is nonlinear due to uric acid’s paradoxical properties (antioxidant and prooxidant) is unclear.MethodsWe searched PubMed, Web of Science, and Embase databases until December 2022. Cohort studies reporting serum uric acid levels and functional outcome, mortality, or neurological complications in patients with acute ischemic stroke were included. Summary effect estimates were calculated using a random-effect model. Moreover, dose–response relationships were assessed by the generalized least squares trend estimation.ResultsAltogether, 13 cohort studies were identified in this study. Compared to the lowest baseline serum uric acid levels, the highest levels were associated with decreased risk of poor functional outcome (OR = 0.70, 95% CI 0.54–0.91, I2 = 29%), hemorrhagic transformation (OR = 0.15, 95% CI 0.05–0.42, I2 = 79%), and post-stroke depression (OR = 0.04, 95% CI 0.00–0.95, I2 = 89%), but not associated with mortality and symptomatic intracerebral hemorrhage. A nonlinear relationship was observed in poor functional outcome (U-shaped, P for nonlinearity = 0.042), hemorrhagic transformation (inverse, P for nonlinearity = 0.001), and post-stroke depression (inverse, P for nonlinearity = 0.002). In addition, there was a single study reporting a U-shaped association in post-stroke epilepsy (P for nonlinearity <0.001). Furthermore, another study reported a positive curvilinear association in stroke recurrence (P for nonlinearity <0.05). The insufficient number of original articles for some prognostic indicators should be considered when interpreting the results of this meta-analysis.ConclusionIn patients with acute ischemic stroke, serum uric acid levels are nonlinearly associated with the risk of poor functional outcome (U-shaped). More evidence is needed to confirm the association between serum uric acid levels and neurological complications following acute ischemic stroke.

【 授权许可】

Unknown   
Copyright © 2023 Zhang, Cheng, Fu and Zhan.