Tariq Muhammad Ali, Shamim Sohaib A, Rana Kiran F, Saeed Aisha, Malik Bilal Haider
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2019 Oct 28;11(10):e6007. doi: 10.7759/cureus.6007.
Over the last decades several studies among the adult population have attempted to establish a correlation between the risk of stroke incidence and serum uric acid (SUA) concentration, and how these levels influence the patient's neurological outcome after a stroke. But, to date, the results are conflicting. In this review, an extensive literature search was performed through PubMed for articles published until May 2019 to review the association. The study selection was narrowed by searching PubMed database using the Medical Subject Headings (MesH) and associated keywords. Only articles conducted in English and on human subjects were included. We considered an article for this review if it had statistics on either the incidence, stroke mortality or post-stroke functional outcomes along with serum uric acid levels in adults. This review includes 21 articles with data of 33,580 cases of stroke and 1,100,888 participants. We can divide the articles reviewed into two separate cohorts of studies. One relates serum uric acid levels to stroke frequency and mortality, while the other is associated with serum uric acid and outcomes for stroke survivors. Based on our review, no significant relationship is observed with uric acid exhibiting protective effects on stroke outcome. Large clinical trials are advised to provide well-defined solutions to further assess the benefits of uric acid level lowering treatment in patients of vascular events, such as a stroke. However, we confidently report that increasing uric acid levels poses a higher risk for incidence of stroke.
在过去几十年中,针对成年人群体开展了多项研究,试图确定中风发病率风险与血清尿酸(SUA)浓度之间的相关性,以及这些水平如何影响中风患者的神经学预后。但是,迄今为止,结果相互矛盾。在本综述中,通过PubMed对截至2019年5月发表的文章进行了广泛的文献检索,以回顾这种关联。通过使用医学主题词(MeSH)和相关关键词搜索PubMed数据库,缩小了研究选择范围。仅纳入以英文发表且针对人类受试者的文章。如果一篇文章包含关于成年人中风发病率、中风死亡率或中风后功能结局以及血清尿酸水平的统计数据,我们就将其纳入本综述。本综述纳入了21篇文章,涉及33580例中风病例和1100888名参与者的数据。我们可以将所综述的文章分为两个独立的研究队列。一个队列将血清尿酸水平与中风频率和死亡率相关联,另一个队列则将血清尿酸与中风幸存者的结局相关联。基于我们的综述,未观察到尿酸对中风结局具有保护作用的显著关系。建议开展大型临床试验,以提供明确的解决方案,进一步评估降低尿酸水平治疗对血管事件(如中风)患者的益处。然而,我们有信心报告,尿酸水平升高会增加中风发病风险。