Serum uric acid concentrations and risk of intracerebral hemorrhage: A systematic review and meta-analysis. (August 2018)

• Record Type: Journal Article
• Authors: Zhou, Zhike; Liang, Yifan; Lin, Jueying; Zhang, Xiaoqian; Qu, Huiling; Xu, Junjie; Zhao, Chuansheng; Zhao, Mei
• Is Part Of: Atherosclerosis. Volume 275(2018)
• Page Start: 352
• Page End: 358
• Publication Date: 2018-08
• Subjects: Serum uric acid -- Intracerebral hemorrhage -- Meta-analysis; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2018.07.002
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: The relationship between serum uric acid (UA) and the risk of intracerebral hemorrhage (ICH) remains controversial. The aim of our systematic review and meta-analysis was to ascertain the association between serum UA concentrations and the risk of ICH. Methods: We systematically searched databases of Embase, Pubmed, Web of Science and Cochrane Library up to December 30, 2017, and additional papers were identified through a manual search. Mean difference (MD) for serum UA levels with 95% confidence intervals (CI) was calculated. Six studies, including 345 ICH patients, 574 ischemic stroke patients and 535 healthy controls, were identified for meta-analysis. Results: Our results revealed no statistically significant differences in the comparison of UA between ICH and healthy controls (95% CI = −9.04-15.61); UA levels in patients with ischemic stroke were significantly higher than those in healthy controls (95% CI = 3.91–56.32); further subgroup analysis of age showed higher UA levels in ICH patients over 65 years than healthy controls (age≥65: 95% CI = 1.44–35.96). Subgroup of ethnicity (Asians: CI = −9.06-21.00; Caucasians: 95% CI = −68.43-8.43), gender (Men: 95% CI = −56.08-4.73; Women: 95% CI = −27.19-35.91) and sample size (large samples: 95% CI = −20.54-41.05; small samples: 95% CI = −25.41-13.78) with respect to UA levels between ICH and healthy controls did not change these results. Conclusions: This meta-analysis showed that serum UA levels did not increase the risk of ICH probably because of the dual roles of UA, i.e. pro-oxidant and antioxidant, in the progression of atherosclerosis. However, serum UA may be a potential risk factor for ICH in the elderly. There were no race-specific differences in UA levels between Asians and Caucasians as well as gender-related differences between men and women in the risk of ICH. Graphical abstract: Image 1 Highlights: Serum uric acid did not increase the risk of intracerebral hemorrhage, the reason of which might be that the dual roles of uric acid i.e. pro-oxidant and antioxidant have potential mechanisms linking the pathogenesis of intracerebral hemorrhage. Higher levels of serum uric acid were found in patients of ischemic stroke than those of healthy controls, which implied that hyperuricemia might be a risk factor for ischemic stroke. In the subgroup analysis of age, serum UA was positively associated with the risk of ICH in patients over 65 years old, which suggested serum UA might be a potential risk factor for ICH in the elderly. There were no race-specific differences and gender-related differences in uric acid levels on the risk of intracerebral hemorrhage.