Prospective study of serum uric acid and risk of brain infarction / 中华神经科杂志

ABSTRACT

Objective To prospectively investigate the association between serum uric acid concentration and the risk of brain infarction in Chinese adults.Methods In this prospective cohort study,a total of 95 738 participants (aged 18-98 years old) were included and were categorized into sex-specific quintiles according to serum uric acid concentration which were collected during 2006-2007 by health examinations.The study was followed up for an average of 4 years.We used Cox regression models to calculate hazard ratios (HR) and their 95％ confidence intervals (CI).Results (1) Higher concentrations of serum uric acid were associated with older age,obesity,higher blood pressure,higher serum concentrations of total cholesterol,triglycerides,and high sensitivity C-reactive protein,smoking,alcohol drinking,history of hypertension,hyperlipidemia and atrial fibrillation,and antihypertensive medication use.(2) The incidence of brain infarction for sex-specific quintiles were 0.84％ (33/3913),0.35％ (14/3985),0.44％(17/3888),0.54％ (21/3909),0.91％ (35/3860) in women (x2 =15.676,P =0.003) and 1.18％(180/15 238),1.26％ (191/15 170),1.11％ (170/15 323),1.45％ (221/15 216),1.82％ (277/15 236)in men (x2 =36.641,P =0.000).(3) After adjusting for potential confounders,including age,body mass index,blood pressure,fasting plasma glucose,total cholesterol,triglyceride,smoking,alcohol,and medical history of major chronic conditions and antihypertensive medication use,the HR (95％ CI) of brain infarction across serum uric acid quintiles were 2.06 (1.14-3.72),0.91 (0.45-1.84),1.00 (ref),1.11 (0.58-2.09),1.31(0.73-2.34) in women and 1.07 (0.86-1.34),1.02 (0.47-2.25),1.00 (ref),1.23(1.00-1.52),1.24(1.01-1.52) in men.Conclusions In this prospective cohort study,we find a U-shaped relationship between serum uric acid concentrations and brain infarction,a higher risk of developing brain infarction in association with low or high serum uric acid concentrations.Women with lowest or highest serum uric acid concentrations and men with higher serum uric acid concentrations are more likely to develop brain infarction.This probably because women have lower serum uric acid concentrations relative to men.Confirmation of our findings in larger cohorts with longer follow-up duration is warranted.