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Association Between Serum Uric Acid Levels and Cognitive Function in Patients with Ischemic Stroke and Transient Ischemic Attack (TIA): A 3-Month Follow-Up Study

Authors Liu Q, Liao X, Pan Y, Jin A, Zhang Y

Received 8 January 2021

Accepted for publication 22 February 2021

Published 31 March 2021 Volume 2021:17 Pages 991—999

DOI https://doi.org/10.2147/NDT.S300893

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Jun Chen


Qi Liu,1 Xiaoling Liao,1 Yuesong Pan,2 Aoming Jin,2 Yumei Zhang3

1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China; 3Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Yumei Zhang
Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, 119#Nan Si Huan Xi Lu, Beijing, 100070, People’s Republic of China
Tel +86 136-9140-4106
Email [email protected]

Purpose: Cognitive impairment is a common complication after stroke and transient ischemic attack (TIA). The relationship between serum uric acid (SUA) and post-stroke cognitive impairment (PSCI) is controversial. This study evaluated the association of different SUA levels in the normal range and PSCI at 3 months.
Patients and Methods: A total of 1523 patients with ischemic stroke/TIA were recruited from the Impairment of Cognition and Sleep (ICONS) subgroup of the China National Stroke Registry-3 (CNSR-3). SUA concentration was assessed at baseline. Global cognitive status was evaluated using the Montreal Cognitive Assessment (MoCA). The main clinical outcome was the incidence of PSCI assessed at 3 months after stroke/TIA. The association between SUA status and the risk of PSCI was assessed with multiple regression models adjusted for potential covariates.
Results: Among the 1523 patients (1391 (91.33%) stroke patients and 132 (8.67%) TIA patients), 747 (49.05%) patients had PSCI at 3 months. Compared to the reference group, there was an increased risk of PSCI in males with SUA levels in the first (OR=1.76) and fourth quartiles (OR=1.47). A U-shaped association between SUA levels and the incidence of PSCI with an inflection point of 297 mmol/L was also found in males. However, there was no association between SUA levels and PSCI in females.
Conclusion: The association between SUA and PSCI differed between males and females. In males, both low and high SUA levels were associated with relatively higher incidences of PSCI, supporting a U-shaped association between SUA levels and PSCI.

Keywords: uric acid, cognitive impairment, stroke, transient ischemic attack, U-shaped curve

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