Serum Uric Acid Levels at Admission Could Predict the Chronic Post-stroke Fatigue

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2022 Mar 11

PMID 35273991

Authors

Wenwei Ren

Junxin Wu

Zijing Wu

Shuang Yang

Xiaofang Jiang

Minjie Xu

Beilan Wu

Caixia Xie

Jincai He

Xin Yu

Affiliations

Soon will be listed here.

Abstract

Background: Post-stroke fatigue (PSF) is a frequent complication of stroke. Serum uric acid (SUA) is frequently thought to be a risk factor for stroke. This study aimed to investigate whether SUA also played a role in PSF.

Methods: Subjects with ischemic stroke were screened from The First Affiliated Hospital of Wenzhou Medical University between January 2020 and October 2020. Patients' fatigue symptoms were assessed by the Fatigue severity scale (FSS). To investigate the relationship between SUA and PSF, binary logistic regression analysis was conducted, with the confounders being controlled. SUA levels were divided into four layers (Q1 ≤ 245 μmol/L; Q2 246-308 μmol/L; Q3 309-365 μmol/L; Q4 ≥366 μmol/L) based on the quartiles.

Results: SUA levels were significantly higher in the PSF group (345.96 ± 73.78 μmol/L) than the non-PSF group (295.97 ± 87.8 μmol/L, < 0.001). There were no differences in any other variables between these two groups. After adjusting the confounders, the risk of PSF in the Q4 layer (≥366 μmol/L) was 6.05 times (95% CI 1.79-20.43, = 0.004) higher than that in Q1 (≤245 μmol/L).

Conclusion: High SUA at admission was an independent risk factor for fatigue 1 year after stroke onset. High SUA (≥366 μmol/L) during stroke deserves more attention, and active control of high SUA levels may be beneficial to reduce the incidence of PSF in the chronic stage following stroke.

Citing Articles

Personalized Biomarkers and Neuropsychological Status Can Predict Post-Stroke Fatigue.

Zhang H, Liu G, Zhang L, Wei W Brain Sci. 2023; 13(2).

PMID: 36831838 PMC: 9953956. DOI: 10.3390/brainsci13020295.

References

Christensen D, Johnsen S, Watt T, Harder I, Kirkevold M, Andersen G . Dimensions of post-stroke fatigue: a two-year follow-up study. Cerebrovasc Dis. 2008; 26(2):134-41. DOI: 10.1159/000139660. View

Moccia M, Lanzillo R, Palladino R, Russo C, Carotenuto A, Massarelli M . Uric acid: a potential biomarker of multiple sclerosis and of its disability. Clin Chem Lab Med. 2014; 53(5):753-9. DOI: 10.1515/cclm-2014-0744. View

Ormstad H, Aass H, Amthor K, Lund-Sorensen N, Sandvik L . Serum cytokine and glucose levels as predictors of poststroke fatigue in acute ischemic stroke patients. J Neurol. 2011; 258(4):670-6. PMC: 3065647. DOI: 10.1007/s00415-011-5962-8. View

Weir C, Muir S, Walters M, Lees K . Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke. 2003; 34(8):1951-6. DOI: 10.1161/01.STR.0000081983.34771.D2. View

Auinger P, Kieburtz K, McDermott M . The relationship between uric acid levels and Huntington's disease progression. Mov Disord. 2010; 25(2):224-8. PMC: 2831113. DOI: 10.1002/mds.22907. View

De Doncker W, Dantzer R, Ormstad H, Kuppuswamy A . Mechanisms of poststroke fatigue. J Neurol Neurosurg Psychiatry. 2017; 89(3):287-293. DOI: 10.1136/jnnp-2017-316007. View

Ruggiero C, Cherubini A, Ble A, Bos A, Maggio M, Dixit V . Uric acid and inflammatory markers. Eur Heart J. 2006; 27(10):1174-81. PMC: 2668163. DOI: 10.1093/eurheartj/ehi879. View

Gaab J, Rohleder N, Heitz V, Engert V, Schad T, Schurmeyer T . Stress-induced changes in LPS-induced pro-inflammatory cytokine production in chronic fatigue syndrome. Psychoneuroendocrinology. 2004; 30(2):188-98. DOI: 10.1016/j.psyneuen.2004.06.008. View

Li G, Miao J, Sun W, Song X, Lan Y, Zhao X . Lower Serum Uric Acid Is Associated With Post-Stroke Depression at Discharge. Front Psychiatry. 2020; 11:52. PMC: 7040095. DOI: 10.3389/fpsyt.2020.00052. View

10.

Lu Y, Yang R, Jiang X, Yang Y, Peng F, Yuan H . Serum metabolite profiles of postoperative fatigue syndrome in rat following partial hepatectomy. J Clin Biochem Nutr. 2016; 58(3):210-5. PMC: 4865597. DOI: 10.3164/jcbn.15-72. View

11.

Corry D, Eslami P, Yamamoto K, Nyby M, Makino H, Tuck M . Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008; 26(2):269-75. DOI: 10.1097/HJH.0b013e3282f240bf. View

12.

Sun J, Lv X, Gao X, Chen Z, Wei D, Ling Y . The association between serum uric acid level and the risk of cognitive impairment after ischemic stroke. Neurosci Lett. 2020; 734:135098. DOI: 10.1016/j.neulet.2020.135098. View

13.

MacIntosh B, Edwards J, Kang M, Cogo-Moreira H, Chen J, Mochizuki G . Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance. Front Aging Neurosci. 2017; 9:343. PMC: 5671553. DOI: 10.3389/fnagi.2017.00343. View

14.

Winward C, Sackley C, Metha Z, Rothwell P . A population-based study of the prevalence of fatigue after transient ischemic attack and minor stroke. Stroke. 2009; 40(3):757-61. DOI: 10.1161/STROKEAHA.108.527101. View

15.

Lerdal A, Lee K, Bakken L, Finset A, Kim H . The Course of Fatigue during the First 18 Months after First-Ever Stroke: A Longitudinal Study. Stroke Res Treat. 2011; 2012:126275. PMC: 3189618. DOI: 10.1155/2012/126275. View

16.

Feig D, Kang D, Johnson R . Uric acid and cardiovascular risk. N Engl J Med. 2008; 359(17):1811-21. PMC: 2684330. DOI: 10.1056/NEJMra0800885. View

17.

Eilertsen G, Ormstad H, Kirkevold M . Experiences of poststroke fatigue: qualitative meta-synthesis. J Adv Nurs. 2012; 69(3):514-25. DOI: 10.1111/jan.12002. View

18.

Krupp L, Larocca N, Steinberg A . The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989; 46(10):1121-3. DOI: 10.1001/archneur.1989.00520460115022. View

19.

Zimmer P, Baumann F, Oberste M, Schmitt J, Joisten N, Hartig P . Influence of Personalized Exercise Recommendations During Rehabilitation on the Sustainability of Objectively Measured Physical Activity Levels, Fatigue, and Fatigue-Related Biomarkers in Patients With Breast Cancer. Integr Cancer Ther. 2017; 17(2):306-311. PMC: 6041930. DOI: 10.1177/1534735417713301. View

20.

Glader E, Stegmayr B, Asplund K . Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden. Stroke. 2002; 33(5):1327-33. DOI: 10.1161/01.str.0000014248.28711.d6. View