Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
CNS Neurosci Ther. 2023 Apr;29(4):1168-1177. doi: 10.1111/cns.14094. Epub 2023 Jan 17.
Inflammation plays an important role in the pathological progress associated with stroke. Serum uric acid (SUA) to lymphocyte ratio (ULR), a novel inflammatory biomarker, has been considered as a better risk stratification tool of adverse outcomes than SUA or lymphocyte alone. This study aimed to investigate whether ULR produced more predictive value for stroke and explore the potential mediators of the associations.
This study enrolled 93,023 Chinese participants without stroke and myocardial infarction at baseline. Cox proportional hazard models were used to analyze the associations of ULR with stroke and subtypes. Mediation analyses were conducted to explore potential mediators of the associations.
During a median follow-up of 13.00 years, 6081 cases of incident stroke occurred, including 5048 cases of ischemic stroke (IS) and 900 cases of hemorrhagic stroke (HS). After adjustment for confounders, the Q4 group was associated with a higher risk of HS (HR, 1.25; 95% CI, 1.03-1.50), but not with total stroke (HR, 1.07; 95% CI, 1.03-1.13) or IS (HR, 1.04; 95% CI, 0.97-1.12). No significant associations were found between SUA or lymphocyte and any stroke. ULR outperformed SUA or lymphocytes alone in predicting stroke. Additionally, the significant association between ULR and HS was partially mediated by systolic blood pressure (20.32%), diastolic blood pressure (11.18%) and estimated glomerular filtration rate (9.19%).
ULR was significantly associated with the risk of HS, but not with IS. Systolic blood pressure, diastolic blood pressure and estimated glomerular filtration rate were potential mediators for the association.
炎症在与中风相关的病理进程中起着重要作用。血清尿酸（SUA）与淋巴细胞比值（ULR），一种新的炎症生物标志物，被认为是比 SUA 或淋巴细胞更能对不良结局进行风险分层的工具。本研究旨在探讨 ULR 是否对中风有更高的预测价值，并探索其关联的潜在介导因素。
本研究纳入了 93023 名基线时无中风和心肌梗死的中国参与者。使用 Cox 比例风险模型分析 ULR 与中风及其亚型的相关性。进行中介分析以探索相关性的潜在介导因素。
在中位随访 13.00 年期间，发生了 6081 例中风事件，包括 5048 例缺血性中风（IS）和 900 例出血性中风（HS）。在校正混杂因素后，Q4 组与 HS 的风险增加相关（HR，1.25；95%CI，1.03-1.50），但与总中风（HR，1.07；95%CI，1.03-1.13）或 IS（HR，1.04；95%CI，0.97-1.12）无关。SUA 或淋巴细胞与任何中风均无显著相关性。与 SUA 或淋巴细胞单独相比，ULR 能更好地预测中风。此外，ULR 与 HS 之间的显著相关性部分由收缩压（20.32%）、舒张压（11.18%）和估算肾小球滤过率（9.19%）介导。
ULR 与 HS 风险显著相关，但与 IS 无关。收缩压、舒张压和估算肾小球滤过率可能是其关联的潜在介导因素。
