Department of Neurology, Second Hospital, Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.
Sci Rep. 2023 May 2;13(1):7097. doi: 10.1038/s41598-023-34352-z.
The relationship between serum uric acid (SUA) and poor cognitive performance in patients with ischemic stroke is unclear. We hypothesized that the severity of renal function mediates the association between SUA and cognitive dysfunction.A retrospective analysis of 608 patients with ischemic stroke was conducted between 2016 and 2020. SUA was obtained from inpatient medical records. Global cognitive function via mini-mental state exam (MMSE) and Montreal Cognitive Assessment (MoCA) was determined one month after hospital discharge. The relationship between SUA and cognitive function was assessed by multiple linear and logistic regression analyses. Patients had a mean age of 66.6 years (SD: 4.1 years), and 52% were male. The mean SUA level was 298.6 ± 75.4 μmol/L. SUA increases were significantly positively associated with lower MMSE and MoCA scores and increased risk of moderate-severe cognitive impairment one month after stroke (p < 0.01), even after adjusting for factors including age, gender, BMI, diabetes and hypertension history. Adding a term for estimated glomerular filtration rate (eGFR) attenuated these associations such that SUA was no longer associated with cognitive performance. A fully adjusted stronger negative association between SUA and cognitive performance was found in those who had lower eGFR, with a significant eGFR interaction for MMSE (p-interaction = 0.016) and MoCA (p-interaction = 0.005). In patients with ischemic stroke, SUA showed an inverse association with cognitive function among those who have lower eGFR. The renal function might mediate the association between SUA and cognitive dysfunction.
血清尿酸（SUA）与缺血性脑卒中患者认知功能障碍之间的关系尚不清楚。我们假设肾功能的严重程度会调节 SUA 与认知功能障碍之间的关联。
对 2016 年至 2020 年间 608 例缺血性脑卒中患者进行了回顾性分析。SUA 从住院病历中获得。出院后一个月，通过简易精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）来确定整体认知功能。通过多元线性和逻辑回归分析评估 SUA 与认知功能之间的关系。患者的平均年龄为 66.6 岁（标准差：4.1 岁），52%为男性。SUA 平均水平为 298.6±75.4 μmol/L。SUA 升高与 MMSE 和 MoCA 评分降低以及脑卒中后一个月发生中重度认知障碍的风险增加呈显著正相关（p<0.01），即使在校正了年龄、性别、BMI、糖尿病和高血压病史等因素后也是如此。加入估计肾小球滤过率（eGFR）项后，这些关联减弱，SUA 与认知表现不再相关。在 eGFR 较低的患者中，SUA 与认知表现之间存在更强的负相关，且 MMSE（p 交互=0.016）和 MoCA（p 交互=0.005）的 eGFR 交互作用具有统计学意义。在缺血性脑卒中患者中，SUA 与认知功能呈负相关，而 eGFR 较低的患者则表现更为明显。肾功能可能介导 SUA 与认知功能障碍之间的关联。
