Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
J Mol Neurosci. 2020 Jan;70(1):94-101. doi: 10.1007/s12031-019-01404-x. Epub 2019 Sep 5.
Uric acid (UA) is an antioxidant with neuroprotective effects in experimental stroke models. Whether serum UA plays a role in hemorrhagic transformation (HT) remains unclear. We aimed to explore the association between serum UA and HT in patients with acute ischemic stroke (AIS). AIS patients within 7 days after stroke onset were consecutively enrolled between January 2016 and October 2017. Patients were categorized into three groups according to serum UA tertiles by sex. HT was detected by follow-up CT or MRI within 7 days after admission. The multivariate logistic analysis was performed to assess the association of serum UA with HT. We included 1230 patients (mean age 64.1 years, 63.5% males) and 133 (10.8%) patients experienced HT. After adjusting confounders, patients in the second and third UA tertiles showed a significant decrease in HT compared with those in the lowest tertile (OR 0.432, 95% CI 0.266-0.702; OR 0.033, 95% CI 0.013-0.086, respectively). Similar results were observed for sex-based subgroups. Males with higher UA had lower risk of HT compared with the lowest UA tertile (OR 0.332, 95% CI 0.170-0.651; OR 0.008, 95% CI 0.001-0.070, respectively). In females, the highest UA tertile was inversely associated with HT (OR 0.148, 95% CI 0.058-0.376). Multiple-adjusted spline regression analyses further confirmed the dose-response relationship between UA levels and HT. Higher serum UA is independently associated with lower HT following stroke. More studies are needed to elucidate the potential neuroprotective mechanism of serum UA and its link to HT.
尿酸（UA）是实验性中风模型中的一种抗氧化剂，具有神经保护作用。血清 UA 是否在出血性转化（HT）中起作用尚不清楚。本研究旨在探讨急性缺血性脑卒中（AIS）患者血清 UA 与 HT 的关系。2016 年 1 月至 2017 年 10 月连续纳入发病 7 天内的 AIS 患者。根据性别将患者的血清 UA 三分位值分为三组。入院后 7 天内通过随访 CT 或 MRI 检测 HT。采用多变量逻辑回归分析评估血清 UA 与 HT 的相关性。共纳入 1230 例患者（平均年龄 64.1 岁，63.5%为男性），其中 133 例（10.8%）患者发生 HT。校正混杂因素后，与 UA 最低三分位值组相比，UA 第二和第三三分位值组 HT 的发生率显著降低（OR 0.432，95%CI 0.266-0.702；OR 0.033，95%CI 0.013-0.086）。基于性别亚组的分析也得到了相似的结果。与 UA 最低三分位值组相比，男性 UA 水平较高时发生 HT 的风险较低（OR 0.332，95%CI 0.170-0.651；OR 0.008，95%CI 0.001-0.070）。女性 UA 最高三分位值组与 HT 呈负相关（OR 0.148，95%CI 0.058-0.376）。多因素校正样条回归分析进一步证实了 UA 水平与 HT 之间的剂量-反应关系。较高的血清 UA 与脑卒中后较低的 HT 独立相关。需要进一步研究以阐明血清 UA 的潜在神经保护机制及其与 HT 的关系。
