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

Qi Liu; Xiaoling Liao; Yuesong Pan; Aoming Jin; Yumei Zhang

doi:10.2147/NDT.S300893

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

Neuropsychiatr Dis Treat. 2021 Mar 31:17:991-999. doi: 10.2147/NDT.S300893. eCollection 2021.

Authors

Qi Liu¹, Xiaoling Liao¹, Yuesong Pan², Aoming Jin², Yumei Zhang³

Affiliations

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

Abstract

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: U-shaped curve; cognitive impairment; stroke; transient ischemic attack; uric acid.

Grants and funding

This work was granted by National Key R&D Program of China (2018YFC1312903), National Science and Technology Major Project (2017ZX09304018), Beijing Municipal Science & Technology Commission (D171100003017002, Z181100001818001) and National Natural Science Foundation of China (81972144).