Arévalo-Lorido José Carlos, Carretero-Gómez Juana, Robles Pérez-Monteoliva Nicolás Roberto
1 Internal Medicine Department, Zafra County Hospital, Badajoz, Spain.
2 Nephrology Department, University Hospital "Infanta Cristina", Badajoz, Spain.
Vascular. 2019 Feb;27(1):19-26. doi: 10.1177/1708538118797551. Epub 2018 Sep 11.
The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease.
Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis.
A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 -1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005).
Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.
血清尿酸在缺血性卒中中的作用存在争议。一方面，它在急性期具有神经保护作用，但另一方面，它可能会促进颈动脉粥样硬化。我们的目的是研究急性缺血性卒中患者入院时血清尿酸水平与颈动脉疾病之间的关联。
对因急性缺血性卒中入院的患者进行横断面研究。记录临床和实验室变量。根据颈动脉超声内膜中层厚度和狭窄情况定义颈动脉疾病。根据这些结果对患者进行分组。采用稳健的统计方法进行分析。
通过卒中登记系统共招募了245例患者。他们的血清尿酸值与颈动脉内膜中层厚度和狭窄均相关，Pearson相关性分析显示血清尿酸水平与内膜中层厚度呈正相关（p < 0.05）。同样，在调整所有潜在混杂因素、估算肾小球滤过率（eGFR）、血糖、年龄和血清尿酸水平后，发现估算肾小球滤过率、血糖、年龄和血清尿酸水平（比值比[OR] 1.26，95%置信区间[CI] 1.04 - 1.52，p = 0.01）是内膜中层厚度≥1毫米的独立预测因素。同样，通过将患者按血清尿酸分布的三分位数分组，我们发现血清尿酸水平最高的三分位数组中颈动脉疾病更为普遍（p < 0.005）。
我们的研究支持以下假设，即血清尿酸水平在缺血性卒中情况下具有不同作用。其对血管壁的影响有助于动脉粥样硬化和颈动脉疾病的发展。
