Serum Uric Acid Levels in Patients with Acute Stroke

Stroke is one of the leading causes of mortality and morbidity worldwide affecting approximately 20 million people each year and causing 5 million deaths (1). Numerous risk factors are involved in the development of stroke such as hypertension, cigarette smoking, hyperlipidemia and diabetes. Recent studies indicate that there may be other factors influencing the development or course of disease like serum levels of uric acid. Uric acid levels are influenced by age and sex. Women typically have 1 mg/dl less uric acid than men. This lower level in women apparently reflects estrogen related enhancement of renal urate clearance (2). Serum uric acid may be considered as a marker of acute endothelial dysfunction, since hyperuricemia has been observed to be associated with raised endothelin levels, and there is evidence of uric acid involvement, via purine metabolism, in the process of thrombus formation (3). However, studies regarding role of uric acid in stroke have produced inconsistent results so far (4,5). Higher risk of stroke incidence and mortality was reported in cases of hyperunicemia (6-8). But contrary to this, other studies have advocated uric acid to be neuroprotective due to its antooxidation action (9-11). Some studies have found higher levels of serum uric acid to be associated with Introduction Abstract The role of uric acid in patients with stroke or other vascular disease is contentious and there is conflicting data on this subject. In this study, we assessed serum uric acid levels in patients with acute stroke and computed its association with other cerebrovascular risk factors. In this cross sectional study, we assessed patients with acute stroke who were admitted in Government Medical College Jammu from September 2013 to july2014. Detailed history and physical examination was performed in all patients and their serum uric acid level besides routine investigations was performed. A total of one hundred patients with acute stroke were evaluated, of whom 41% were women and 59% were men. History of hypertension was known in 64% of cases. 8% of patients were smoker, three patients had atrial fibrillation and history of snake bite was present in one patient. Mean age of patients was 65.84± 13.37 years. 54% had ischemic stroke and hemorrhagic stroke was seen in 46% of cases. Mean uric acid was 6.14±1.17. Mean uric acid in men was 6.72±0.67 and women had mean uric acid of 5.74±0.81. High uric acid level was seen in 45% of cases. There was negative correlation between age of patients and serum uric acid level (r=-0.19, p=0.18).There was statistically significant difference in uric acid between men and women (p=0.01).Due to the high prevalence of hyperuricemia in patients with acute stroke, it can be considered as a risk factor for acute stroke.