DOI: http://dx.doi.org/10.18203/2349-3933.ijam20161098

Serum uric acid level in patients of acute stroke

Chandan Prasad, Naresh Chandra Dwivedi, Poonam Gupta, Shailendra Kumar Shukla, Rita Shukla, Rakesh Kumar Yadav, Sujit Verma

Abstract


Background: Controversial results regarding the association of serum uric acid (SUA) with acute stroke and its mortality outcome are consistently reported. Hence, present study was done to estimate SUA as a risk factor and its prognostic significance in patients of acute stroke.

Methods: Total 110 patients of acute cerebrovascular accidents admitted were studied and serum uric acid was measured within 48 hours of admission.

Results: The study comprised of 66 males and 44 females of whom 63 had hemorrhagic and 47 had ischemic stroke. Mean SUA of cases was 6.69±2.34mg/dl was significantly higher than age and sex matched controls. 50% of cases were found to be hyperuricemic. Mean SUA was greater in males, elderly (>60 years), diabetics, hypertensive, ischemic stroke patients, but their difference was not found to be statistically significant. However, mean SUA level in dyslipidemics (7.07±2.29) mg/dl was significantly higher. Prevalence of hyperuricemia was highest among patients with low HDL (58.33%).Mean SUA in expired cases was significantly higher than survived. Also among stroke subtypes, mean SUA was significantly higher in expired than survived ischemic stroke cases.

Conclusions: The study concludes that SUA level was significantly elevated in patients of acute stroke. Elevated SUA was associated with higher mortality, more in ischemic stroke patients. Hence, SUA can be considered as a risk factor and poor mortality outcome in patients of acute stroke.


Keywords


Uric acid, Cerebrovascular accident, Ischemic, Hemorrhagic, Stroke subtypes

Full Text:

PDF

References


World Health Organization. http://www.who.int/ mediacentre/factsheets/fs310/en/Fact sheet N°310. Updated May 2014.

Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA. 2000;283(18):2404-10.

Hariklia VD, Apostolos H, Haralambosk. The role of uric acid in stroke. The issue remains unresolved. The Neurologist. 2008;14:238-42.

Yadav SK, Nepal N, Niroula D. Prevalence of hyperuricemia among people of morang district of nepal. Journal of Nobel Medical College. 2014;13;3(1):16-21.

Uaratanawong S, Suraamornkul S, Angkeaw S, Uaratanawong R. Prevalence of hyperuricemia in Bangkok population. Clinical rheumatology. 2011;30(7):887-93.

Foerch C, Ghandehari K, Xu G, Kaul S. Exploring gender distribution in patients with acute stroke: A multi-national approach. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2013;18(1):10.

Arjundas D, Pandiyan U, Arjundas G, Henry B. Surveillance of stroke: WHO STEP-wise approach: A Chennai stroke unit report. Annals of Indian Academy of Neurology. 2007;10(3):154.

Vaidya CV, Majmudar DK. A retrospective study of clinical profile of stroke patients from GMERS Medical College and Hospital, Gandhinagar, Gujarat. International Journal of Clinical Trials. 2014;1(2):62-6.

Bonora E, Targher G, Zenere MB, Saggiani F, Cacciatori V, Tosi F, et al. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The verona young men atherosclerosis risk factors study. International journal of obesity and related metabolic disorders. 1996;20(11):975-80.

Bansal BC, Gupta RR, Bansal MR, Prakash C. Serum lipids and uric acid relationship in ischemic thrombotic cerebrovascular disease. Stroke. 1975;6(3):304-7.

Heo SH, Lee SH. High levels of serum Uric acid are associated with silent brain infarctivn. Journal of the Neurol Scien. 2010;297:6-15.

Milionis HJ, Kalantzi KJ, Goudevenos JA, Seferiadis K, Mikhailidis DP, Elisaf MS. Serum uric acid levels and risk for acute ischaemic non-embolic stroke in elderly subjects. J Intern Med. 2005;258(5):435-41.

Shrikrishna R, Suresh DR. Biochemical study of antioxidant profile in acute ischemic stroke. British Journal of Medical Practitioners. 2009;2(1):35-7.

Weir CJ, Muir SW, Walters MR, Lees KR. Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke. 2003;34(8):1951-6.

Mozos I, Chiulana C, Goruna C, Costeab S. Serum uric acid in stroke. Annals of West University of Timisoara, Series of Chemistry. 2007;16(2):227-36.

Waring WS, Webb DJ, Maxwell SRJ. Effect of local hyperuricaemia on endothelial function in the human forearm vascular bed. Br J Clin Pharmacol. 2000;49:511P.

Bagnati M, Perugini C, Cau C, Bordone R, Albano E, Bellomo G. When and why a water-soluble antioxidant becomes pro-oxidant during copper-induced low-density lipoprotein oxidation: a study using uric acid. Biochem J. 1999;340(Pt l):143-52.

Duff GW, Atkins E, Malawista SE. The fever of gout: urate crystals activate endogenous pyrogen production from human and rabbit mononuclear phagocytes. Trans Assoc Am Physicians. 1983:96:234-45.

Berry C, Hamilton CA, Brosnan MJ, Magill FG, Berg GA, McMurray JJ, Dominiczak AF. Investigation into the sources of superoxide in human blood vessels: angiotensin II increases superoxide production in human internal mammary arteries. Circulation. 2000;101(18):2206-12.

Muir SW, Harrow C, Dawson J, Lees KR, Weir CJ, Sattar N, Walters MR. Allopurinol use yields potentially beneficial effects on inflammatory indices in those with recent ischemic stroke: a randomized, double-blind, placebo-controlled trial. Stroke. 2008;39(12):3303-7.

Chamorro A, Obach V, Cerrera A, Revilla M, Deulofeu R, Aponte JH. Prognostic significance of uric acid serum concentration in patients with acute ischemic stroke. Stroke. 2002;33:1048-52.

Mazza A, Pessina AC, Pavei A, Scarpa R, Tikhonoff V, Casiglia E. Predictors of stroke mortality in elderly people from the general population the cardiovascular study in the elderly. Eur J Epidemiol. 2001;17:1097-104.

Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA. Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum. 2009;13:885-92.

Heo SH, Lee SH. High levels of serum uric acid are associated with silent brain infarctivn. Journal of the Neurol Scien. 2010;297:6-15.

Amaro S, Urra X, Gomez-Choco M. Uric acid levels are relevant in patients with stroke treated with thrombolysis. Stroke. 2011;42:28-32.