Sex-specific relationship between serum uric acid levels and the prevalence of large vessel occlusion in acute ischemic stroke.

Purpose: Previous studies have found that uric acid (UA) plays a neuroprotective role in ischemic stroke patients. However, the relationship between serum UA of acute ischemic stroke (AIS) and large vessel occlusion (LVO) strokes is unclear.

Methods: In this retrospective study, 1318 AIS patients were enrolled. All patients underwent imaging examinations to assess the intracranial and carotid vessels. Multivariate logistic regression analysis was conducted to evaluate the relationship between UA levels and the prevalence of LVO.

Results: The 1318 enrolled AIS patients were comprised of 287 LVO and 1031 non-LVO patients. UA levels in males were higher than females (321.04 ± 91.28 vs. 274.43 ± 82.11, < .001). The association between serum UA levels and LVO was modified by sex ( = .007). When serum UA levels were continuous, after adjusting for related risk factors, higher serum UA levels were still associated with a lower prevalence of LVO in males (odds ratio (OR) 0.997, 95% confidence interval (CI) 0.994-0.999), but not in female subjects (OR 0.998, 95% CI 0.995-1.001). When serum UA levels were divided into tertiles, higher UA levels had a lower risk of LVO than the moderate ( = .006) and lower tertiles of UA levels ( = .010) in males, but not in females ( = .402 and = .206 for moderate and low tertiles, respectively).

Conclusions: AIS patients with higher serum UA levels tend to be associated with a lower risk of LVO in males, but not in females.