Jiang Haiyan, Su Yunyi, Liu Ruixue, Xu Xinyi, Xu Qi, Yang Jie, Lin Yapeng
School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan Province, China.
Department of Rheumatology and Immunology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China.
Arch Rheumatol. 2025 Mar 17;40(1):128-143. doi: 10.46497/ArchRheumatol.2025.10808. eCollection 2025 Mar.
The relationship between hyperuricemia (HUA) and stroke remains controversial. In this systematic review, we discuss the association between HUA and stroke.
The PubMed, Embase, Web of Science, and Cochrane Library were searched from their earliest records to March 13, 2024, and additional papers were identified through a manual search. Prospective studies that provided a multivariate-adjusted estimate of the association between HUA and risk of stroke incidence and mortality, represented as relative risks (RRs) with 95% confidence intervals (CIs), were eligible.
A total of 22 studies including 770,532 adults were eligible and included. Hyperuricemia was associated with a significantly increasing risk of both stroke incidence (pooled RR, 1.42; 95% CI, 1.31-1.53) and stroke mortality (pooled RR, 1.53; 95% CI, 1.18-1.99) in our meta-analyses. Relative risk of stroke incidence was as follows: females (pooled RR, 1.67; 95% CI, 1.44-1.92) and males (pooled RR, 1.13; 95% CI, 1.02-1.25). Relative risk of mortality was as follows: female (pooled RR, 1.41; 95% CI, 1.31-1.52) and males (pooled RR, 1.27; 95% CI, 1.20-1.34). For the risk of stroke mortality, the association between HUA and ischemic stroke (pooled RR, 1.39; 95% CI, 1.31-1.47) was more significant than that of hemorrhagic stroke (pooled RR, 1.13; 95% CI, 1.02-1.26).
Our study confirms an association between HUA and risk of stroke, which is more pronounced in females.
高尿酸血症（HUA）与中风之间的关系仍存在争议。在本系统评价中，我们探讨HUA与中风之间的关联。
检索PubMed、Embase、Web of Science和Cochrane图书馆，检索时间从各数据库最早记录至2024年3月13日，并通过手工检索确定其他论文。符合条件的前瞻性研究需提供HUA与中风发病率和死亡率风险之间关联的多变量调整估计值，以相对风险（RRs）及95%置信区间（CIs）表示。
共有22项研究符合条件并纳入分析，涉及770,532名成年人。在我们的荟萃分析中，高尿酸血症与中风发病率（合并RR，1.42；95%CI，1.31 - 1.53）和中风死亡率（合并RR，1.53；95%CI，1.18 - 1.99）的风险显著增加相关。中风发病率的相对风险如下：女性（合并RR，1.67；95%CI，1.44 - 1.92）和男性（合并RR，1.13；95%CI，1.02 - 1.25）。死亡率的相对风险如下：女性（合并RR，1.41；95%CI，1.31 - 1.52）和男性（合并RR，1.27；95%CI，1.20 - 1.34）。对于中风死亡率风险，HUA与缺血性中风之间的关联（合并RR，1.39；95%CI，1.31 - 1.47）比与出血性中风的关联（合并RR；1.13；95%CI，1.02 - 1.26）更显著。
我们的研究证实了HUA与中风风险之间的关联，这种关联在女性中更为明显。
