Elevated Serum Uric Acid Increases the Risk of Ischemic Stroke Recurrence and Its Inflammatory Mechanism in Older Adults

Serum uric acid (UA) has been reported to be associated with ischemic stroke and inflammation. However, whether or not UA is related to the recurrence of ischemic stroke, and whether inflammation plays a role in the relationship between them remain inconclusive. We sought to explore the relationship...

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Published in:Frontiers in aging neuroscience Vol. 14; p. 822350
Main Authors: Zhu, Han-Yu, Zhao, Shu-Zhen, Zhang, Meng-Li, Wang, Yan, Pan, Zhi-Ming, Cheng, Hao-Ran, Zhao, Ke, Wang, Zhen
Format: Journal Article
Language:English
Published: Switzerland Frontiers Research Foundation 08.03.2022
Frontiers Media S.A
Subjects:
Aging
Aging Neuroscience
Arteriosclerosis
Atherosclerosis
Blood
Cardiac arrhythmia
Cardiovascular disease
Cardiovascular diseases
Diabetes
Diabetes mellitus
Gender
Hospitals
Hypertension
Inflammation
interaction and joint analysis
Ischemia
ischemic stroke recurrence
Kidney diseases
Laboratories
Leukocytes (neutrophilic)
Lymphocytes
Magnetic resonance imaging
mediation analysis
Neutrophils
NLR
Older people
Oxidative stress
Patients
Regression analysis
restricted cubic spline regression
Stroke
Uric acid
ischemic stroke recurrence
mediation analysis
restricted cubic spline regression
UA
NLR
interaction and joint analysis
ISSN:1663-4365, 1663-4365
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Summary:Serum uric acid (UA) has been reported to be associated with ischemic stroke and inflammation. However, whether or not UA is related to the recurrence of ischemic stroke, and whether inflammation plays a role in the relationship between them remain inconclusive. We sought to explore the relationship between UA and the recurrence of ischemic stroke and to define the role of neutrophil-to-lymphocyte ratio (NLR) in the aforementioned relationship. A total of 8,995 patients were included in this study. Basic information and blood samples were collected, and whether or not each participant experienced ischemic stroke recurrence within 3 years was documented. Patients were stratified into three groups according to their UA level, as follows: ≤ 266, 267-339, and ≥ 340 μmol/L. COX regression and restricted cubic spline regression models were used to evaluate the clinical correlation between UA and ischemic stroke recurrence, mediation analysis and interaction and joint analysis were used to evaluate the role of NLR in the association of UA and ischemic stroke recurrence, and sensitivity and subgroup analyses were performed to test the robustness of the data. Ischemic stroke recurrence was related to male sex, older age, higher UA level, higher NLR, hypertension, diabetes, and cardiovascular disease. Following adjustment for potential confounders, a high level of UA (≥ 340 μmol/L) increased the risk of recurrence by 92.6% in patients with previous ischemic stroke. We also found that NLR affects the association between UA and the recurrence of ischemic stroke in older adults, suggesting that patients with high NLR and high UA levels are at greater risk for ischemic stroke recurrence. UA level is non-linearly associated with recurrence, and NLR has an additive interaction between UA and ischemic stroke recurrence.
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These authors have contributed equally to this work and share first authorship
Edited by: Changiz Geula, Northwestern University, United States
Reviewed by: Wanlin Yang, Southern Medical University, China; Raluca Elena Sandu, University of Medicine and Pharmacy of Craiova, Romania
This article was submitted to Neuroinflammation and Neuropathy, a section of the journal Frontiers in Aging Neuroscience
ISSN:1663-4365
1663-4365
DOI:10.3389/fnagi.2022.822350