Association Analysis Between Serum Uric Acid Levels And Cerebral Infarction, As Well As Serum Glucose, Blood Pressure, Blood Lipids And C-reactive Protein

PrefaceDuring recent years,both in developed and developing countries,morbidity of hyperuricemia(Hyperuricemia,HUA) has increased rapidly.And a growing number of studies have proved that HUA was one of the components of metabolic syndrome, patients with HUA are usually have problems of obesity,glucose and lipid metabolism disorder,hypertension and cardiovascular disease.However,only a few studies focused on the association between HUA and cerebrovascular disease.But the role of SUA is a matter in dispute,and its physiological functions in the human body are not entirely clear.Therefore,it is necessary to corfirm the association between UA and onset and prognosis of cerebral infarction.Materials and methods1.Clinical dataWe studied 70 patients with cerebral infarction-diagnosed by CT or MRI - who were admitted to Department of Neurology,First affiliated hospital of China Medical University from May 2008 to March 2009.Criteria for inclusion in the study were:(Ⅰ) subjects aged 50 to 70 years;(Ⅱ)normal body mass index;(Ⅲ)suffering from acute cerebral infarction;(Ⅳ) patients within 3 days from the onset of symptoms;(Ⅴ) without receiving treatment.The diagnosis of acute cerebral infarcton was based on the diagnostic criteria amended in the fourth cerebrovascular disease session in 1995. We excluded patients with repeated episodes of cerebral infarction,cerebral infarction secondary to cerebral hemorrhage,trauma,vasculitis,tumor,or hematological disease, and patients with history of gout or renal dysfunction.Volume of infarction is calculated according to formula proposed by Pullicino. Large infarction is defined as larger than 10cm~3 in volume,moderate infarction as 5 -10cm~3,small infarction as less than 5cm~3.Three groups were classcified according to neurological deficit scores of Chinese stroke scale(CSS),(1) mild group,0 to 15 scores;(2) moderate group,16 to 30 scores;(3) severe group,31 to 45 scores.Elevated SUA is defined as greater than 380mmol / L.Control group is consist of out-patients without cerebrovascular disease in the First affiliated hospital of China Medical University,with matched gender and age.MethodsAll biochemical analyses were performed by commercially available standardized methods within 24 h after admission,fasting for 12 hours for all patients and controls. Laboratory investigation included SUA,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),fasting blood glucose (FBG),fibrinogen(Fg) and C-reactive protein(hs-CRP) levels,and all above were performed by Hitachi 7600 automatic biochemical analyzer and related reagents. Moreover,blood pressure measurements(for patients with cerebral infarct as well as for controls) were obtained in a quiet status in triplicate on the subject's nondominant arm using a validated mercury sphygmomanometer,and mean value of blood pressure was recored.Statistical analysisVariable data was expressed as mean±SD,and categorical data was expressed as percent.A comparison of mean between samples was performed by an t-test,whilst chisquared tests were used for categorical variables.Multivariate analysis was performed by logistic regression analysis(Stepwise regression),which allows adjustment for other factors,such as serum glucose,blood hypertension,serum lipids and C-reactive protein.Significance levels were set at P＜0.05 in all cases.SPSS 11.0 for Windows were used to perform the statistical analysis.Results1.The levels of SUA were significantly higher in stroke patients compared with controls(p＜0.05).2.Frequency of stroke was significantly higher in HUA group compared with non-HUA group(p＜0.05).3.The levels of SUA were significantly higher in Large infarction group compared with small nfarction group(P＜0.05);moderate infarction group compared small nfarction group(P＜0.05).The levels of SUA were significantly higher in severe injury group compared with the mild group(P＜0.05);moderate injury group compared with the mild group(P＜0.05).4.Patients in HUA group had significantly higher values of SBP,DBP,TC,TG, LDL-C,FBG and hs-CRP,whereas they displayed significantly lower concentrations of HDL cholesterol.(p＜0.05)5.In Multivariate Logistic regression analysis,the level of SUA has a major effect on scores of CSS(r = 0.52).At the same time,the level of SUA has a major effect on area of cerebral infarction(r = 0.55).ConclusionElevated serum uric acid is a possible risk factor for cerebral infarction,which is associated with severity and volume of cerebral infarction.In addition,levels of SUA are related to the levels of TC,TG,LDL-C,HDL-C,FBG and hs-CRP.