Introduction and objectives:To explore if the clinical neurological damage that hyperglycemia could produce may be attenuated by elevated levels of serum uric acid (SUA). Methods: Prospective registry that included patients with acute ischemic stroke admitted within 24 h after the event. We divided them into three groups according to their levels of fasting blood glucose (FBG) (FBG < 140 mg/dL, FBG 140-180 mg/dL, and FBG ≥ 180 mg/dL) and subdivided them according to SUA levels (> 6 mg/dL in women and > 7 mg/dL in men). We assessed the worsening of both neurological (based on National Institute of Health Stroke Scale [NIHSS]) and functional damage based on Rankin scale. Results: We analyzed 504 patients (53.9% men). Type 2 diabetes mellitus was present in 163 (32.4%) patients and hyperuricemia in 118 (23.4%). The persons belonging to the FBG groups were increasing their neurological (NIHSS) and functional (Rankin) punctuation when their glucose levels raised (p = 0.07). Overall, the groups with hyperuricemia had lower but not significant scores in stroke severity (NIHSS) comparing to the groups without hyperuricemia (p = 0.1). In the logistic regression model, the odds ratio to have a NIHSS score higher than 16 increased as glucose levels were higher and again decreased in the groups with hyperuricemia without reach statistical significance. Conclusion: In patients with acute ischemic stroke with hyperglycemia, we found a non-significant tendency between SUA and lower clinical neurological damage. Further studies with larger samples and prospective follow-up are needed to confirm this potential protective role.

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