Uric Acid and Clinical Outcomes in Young Patients with Ischemic Stroke

Abstract

Background and Purpose There is limited available evidence for the relationship between uric acid (UA) levels and ischemic stroke in young adults. We aimed to explore the association between UA levels and acute ischemic stroke (AIS) in young patients. Materials and Methods This was a prospective and observational study. We recruited young patients aged 18–45 years with AIS at our tertiary hospital. Patients were categorized into four groups according to quartiles of UA levels. The primary outcome was functional outcome at 3 months. The secondary outcomes included stroke severity, in-hospital complications, and functional outcome at discharge. Modified Rankin Scale (mRS) scores were used to assess functional outcome as poor (mRS=2-6) or favorable(mRS=0-1). Results A total of 636 patients were enrolled in the current analysis. The four groups were defined as follows: Q1≤289.8 µmol/L, 289.8 µmol/ L<Q2≤349.0 µmol/L, 349.0 µmol/L<Q3≤421 µmol/L, and Q4>421 µmol/L. Multiple logistic regression analysis showed that UA levels were not significantly predictive of functional outcome either at discharge or at 3 months after AIS. However, compared to Q1, higher UA levels were significantly negatively associated with the rate of moderate-severe stroke (NIHSS≥5) at admission (p for trend =0.016). Furthermore, a reduction in the risk for in-hospital pneumonia was significantly associated with higher UA levels compared to Q1 ( P for trend < 0.0001). Conclusion Serum UA was a protective factor for stroke severity and in-hospital pneumonia after AIS in young patients. However, we were unable to identify the predictive significance of UA for functional outcome either at discharge or at 3 months after AIS.

Clinical Characteristics of Ischemic Stroke Patients <50 Years Old at a University Hospital: A Retrospective Descriptive Study

“…According to our findings, HTN and DM were the most common comorbidities among the patients. This finding is consistent with those of previous studies published in the literature [ 15 , 17 ]. Hypothetically, HTN and DM come with other metabolic disorders such as obesity and hypercholesterolemia, which further increase the risk of stroke [ 7 ].…”

“…The average age of the participants in our study was 36.65 years. This was slightly higher than the mean age of 30.1 years reported in a local study by Alamei et al [ 14 ] and lower than the mean age of 37 years reported in a study of Chinese patients [ 15 ]. This indicates that younger people are more likely to experience strokes.…”

Dual effects of serum urate on stroke risk and prognosis: insights from Mendelian randomization

“…Currently, there is a lack of consensus on the exact role of SUA in stroke prognosis ( 25 , 26 ). In a recent MR study, SUA was not found to be causally associated with poor functional prognosis (mRS > 2) at 90d after ischemic stroke ( 27 ).…”

Serum uric acid and prognosis of ischemic stroke: Cohort study, meta-analysis and Mendelian randomization study

“…Prior studies on serum uric acid levels and post-acute ischemic stroke neurological outcomes yield conflicting res ults, [20][21][22][23][24][25][26][27][28] likely due to multiple factors: differences in sample sizes, outcome assessment methods, potential confounders, and study population characteristics, including geography, ethnicity, gender, age, socio-economic factors, and research methodologies. In our meta-analysis, we identified ethnic heterogeneity as a significant contributor.…”

“…After a thorough evaluation, 10 studies that met the inclusion criteria were included in the final analysis. [20][21][22][23][24][25][26][27][28] The flow chart outlining the metaanalysis process is depicted in Supplemental Figure S2. These studies were conducted in four countries, namely Africa, Britain, China, and Holland, described in detail in Supplemental Table S7.…”