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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| Vydáno v: | Frontiers in aging neuroscience Ročník 14; s. 822350 |
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08.03.2022
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| Abstract | 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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| AbstractList | 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.BackgroundSerum 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.ObjectiveWe 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.MethodsA 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.ResultsIschemic 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.ConclusionUA level is non-linearly associated with recurrence, and NLR has an additive interaction between UA and ischemic stroke recurrence. Background: 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. Objective: 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. Methods: 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 3 groups according to their UA level, as follows:≤266, 267–339, and ≥340μmol/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. Results: 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 (≥340μmol/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. Conclusion: UA level is non-linearly associated with recurrence, and NLR has an additive interaction between UA and ischemic stroke recurrence. BackgroundSerum 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.ObjectiveWe 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.MethodsA 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.ResultsIschemic 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.ConclusionUA level is non-linearly associated with recurrence, and NLR has an additive interaction between UA and ischemic stroke recurrence. 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. |
| Author | Zhao, Ke Cheng, Hao-Ran Wang, Zhen Pan, Zhi-Ming Zhu, Han-Yu Zhao, Shu-Zhen Zhang, Meng-Li Wang, Yan |
| AuthorAffiliation | 1 Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China 4 Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University , Zhuji , China 3 Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University , Wenzhou , China 2 The First Clinical College, Wenzhou Medical University , Wenzhou , China |
| AuthorAffiliation_xml | – name: 4 Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University , Zhuji , China – name: 2 The First Clinical College, Wenzhou Medical University , Wenzhou , China – name: 1 Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China – name: 3 Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University , Wenzhou , China |
| Author_xml | – sequence: 1 givenname: Han-Yu surname: Zhu fullname: Zhu, Han-Yu – sequence: 2 givenname: Shu-Zhen surname: Zhao fullname: Zhao, Shu-Zhen – sequence: 3 givenname: Meng-Li surname: Zhang fullname: Zhang, Meng-Li – sequence: 4 givenname: Yan surname: Wang fullname: Wang, Yan – sequence: 5 givenname: Zhi-Ming surname: Pan fullname: Pan, Zhi-Ming – sequence: 6 givenname: Hao-Ran surname: Cheng fullname: Cheng, Hao-Ran – sequence: 7 givenname: Ke surname: Zhao fullname: Zhao, Ke – sequence: 8 givenname: Zhen surname: Wang fullname: Wang, Zhen |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35350634$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright © 2022 Zhu, Zhao, Zhang, Wang, Pan, Cheng, Zhao and Wang. 2022. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2022 Zhu, Zhao, Zhang, Wang, Pan, Cheng, Zhao and Wang. 2022 Zhu, Zhao, Zhang, Wang, Pan, Cheng, Zhao and Wang |
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| Keywords | ischemic stroke recurrence mediation analysis restricted cubic spline regression UA NLR interaction and joint analysis |
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| License | Copyright © 2022 Zhu, Zhao, Zhang, Wang, Pan, Cheng, Zhao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 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 |
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| Snippet | 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... Background: Serum uric acid (UA) has been reported to be associated with ischemic stroke and inflammation. However, whether or not UA is related to the... BackgroundSerum uric acid (UA) has been reported to be associated with ischemic stroke and inflammation. However, whether or not UA is related to the... |
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| Title | Elevated Serum Uric Acid Increases the Risk of Ischemic Stroke Recurrence and Its Inflammatory Mechanism in Older Adults |
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