Serum uric acid and risk of stroke: a dose-response meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 34025024 · doi:10.3164/jcbn.20-94
What was done
Authors conducted a systematic review and dose-response meta-analysis searching Cochrane, PubMed, Embase, and Web of Science for cohort studies assessing the link between serum uric acid levels and incident stroke. Effect estimates were synthesized using a random-effects model to evaluate high-versus-low exposure categories and model linear or non-linear dose-response relationships.
What was found
Across 21 cohort studies totaling 818,098 participants, the pooled relative risk of stroke for high versus low serum uric acid categories was 1.22 (95% CI: 1.15-1.30). Dose-response modeling identified a non-linear relationship, with the lowest risk of stroke observed at serum uric acid concentrations between 3 and 5 mg/dL.
Why it matters
This study provides large-scale observational evidence linking elevated serum uric acid to stroke risk and identifies a potential target range (3-5 mg/dL) associated with lowest risk.
Limits
The findings rely entirely on observational cohort data, precluding causal conclusions and leaving open the possibility of residual confounding from diet, renal function, or metabolic syndrome. The abstract does not provide subtype stratification (ischemic versus hemorrhagic stroke), geographic or demographic characteristics, or formal metrics of between-study heterogeneity.
Cited by
- supports Elevated serum uric acid levels are associated with an increased risk of stroke.