Abstract
Serum uric acid (UA) has been suggested to be correlated with outcomes after
stroke. We performed a meta-analysis to evaluate the association between serum
UA and post-stroke cognitive impairment (PSCI) in patients with acute ischemic
stroke (AIS). Relevant observational studies were identified by search of
electronic databases including PubMed, Embase, and Web of Science. A
randomized-effect model incorporating the possible between-study heterogeneity
was used to pool the results. Overall, eleven studies with 4246 patients of AIS
were included, 2073 (48.8%) of them had PSCI. Pooled results showed that
patients with PSCI had significantly higher level of serum UA as compared to
those without PSCI (mean difference: 35.70 μmol/l,
95% confidence interval (CI): 8.36 to 63.01, p=0.01;
I2=95%). Subgroup analysis showed significant higher level of
serum UA in patients with PSCI evaluated during follow-up of 3 months to 3
years, but not for those evaluated during hospitalization (p for subgroup
difference=0.01). In addition, results of meta-analysis also showed that
compared to patients with lower serum UA, AIS patients with higher serum UA had
increased risk of PSCI (odds ratio: 1.33, 95% CI: 1.02 to 1.73,
p=0.04; I2=72%). Higher level of serum UA after disease
onset may be a marker of increased risk of PSCI in patients with AIS. Although
these findings need to be validated in large-scale prospective studies, the
possible mechanisms underlying the association between UA and PSCI should be
also investigated.
Key words
uric acid - post-stroke cognitive impairment - cognitive function - acute ischemic
stroke - meta-analysis
