The Study Of The Correlation Between Serum Uric Acid Concentration And Cerebral Small Vessel Disease Patients' Clinical Manifestations And Imaging Characterization

Objective: To understand the characteristics of cerebral small vessel diseases(CSVD)patients' serum uric acid concentration,and to analyze its correlation with clinical manifestations and imaging characterization Methods: In this study,the symptoms of 206 patients with cerebral small vessel disease were followed.MRI examinations,which included T1-weighted imaging,axial T2-weighted imaging,and FLAIR imaging,were performed before enrollment,then brain white matter lesions were quantified according to the Fazekas scale and lacunar infarction grading was determined by the number of infarcts.The fasting blood was collected for deepening index examination,and general information of the patient was also collected.Patients' clinical symptoms were recorded,including gait disturbance,dizziness/vertigo,urinary incontinence,and transient ischemic attack(TIA).The Montreal Cognitive Assessment(MoCA)was used to evaluate cognitive function.Data was analyzed by SPSS 22.0 software..Results:(1)General characteristics: The 206 patients were 41-82 years old,with an average age of 66.2 ± 8.2 years;134 patients were male(65.0%),72 patients were female(35.0%).There were 82 patients(39.2%)with hyperuricemia,and 124 patients(60.2%)with normal blood uric acid level.Patients in hyperuricemia group had significantly higher possibility of having hypertension,diabetes,and drinking compared to those in the normal group(P <0.05),but there was no statistical difference in the distribution of baseline characteristics such as age,gender,education level,BMI,and drinking(P>0.05).(2)Biochemical indicators: The average serum uric acid level of the studied 206 subjects was 366.2±87.3?mol/L,and the average serum uric acid level in patients with hyperuricemia was 453.2±94.5?mol/L.The average serum uric acid level in the normal group was 308.7±101.2?mol/ L,the difference was significant(P<0.001).HOMA-IR,LDL-C and homocysteine in the hyperuricemia group were significantly higher than those in the normal group(P<0.05).(3)Lacunar infarction: 76 patients,with mild lacunar infarction,accounted for 36.9% of all subjects;130 patients,with moderate-severe lacunar infarction,accounted for 63.1% of all subjects.The mean concentrations of serum uric acid in mild and moderate-severe lacunar infarction were 324.5±112.4?mol/L and 390.6±96.5?mol/L,the proportion of hyperuricemia was 27.6% and 46.9%,respectively.The serum uric acid level to hyperuricemia was significantly increased in moderate-severe lacunar infarction(P<0.05).Multivariate conditional logistic regression analysis showed that patients with hyperuricemia,smoking,hypertension,and homocysteinemia had a higher risk of moderate-severe lacunar infarction(P<0.05).(4)Fazekas score: The number of PVH-free,mild PVH,and moderate-severe PVH cases were 25,98,and 83,respectively.Serum uric acid levels in patients with moderate to severe PVH were significantly higher than those in patients with no or mild,and the proportion of hyperuricemia increased with the increase of PVH grade(P <0.05).The number of patients with DWMH-free,mild DWMH,and moderate to severe DWMH were 41,91,and 74,respectively.The mean levels of serum uric acid and hyperuricemia increased along with the DWMH grade(P<0.05).Conditional logistic regression analysis showed patients with hyperuricemia,smoking,advanced age had a higher risk of moderate-severe DWMH(P<0.05).(5)Clinical symptoms: The proportions of cognitive impairment,gait,dizziness and dizziness,urinary incontinence and TIA were 27.9%,47.6%,19.2% and 52.9%,respectively.The incidence dizziness,dizziness and TIA of patients with hyperuricemia was higher(P<0.05).(6)Cognitive function: The median MoCA scores of patients in hyperuricemia group and normal group were 23.5(19.0,26.0)and 25.0(21.0,28.0)respectively.Hyperuricemia group was significantly lower than normal group(P <0.05).The comparison results of different dimensions showed that the visual space/execution and orientation scores of the hyperuricemia group were significantly lower than those of the normal group(P<0.05).Conclusions:(1)The risk factors inducing cerebrovascular disease is correlated to serum uric acid level.(2)Hyperuricemia is the high risk factor of resulting in cerebrovascular disease.Hyperuricemia is the high factor for lacunar infarction and DWMH.(3)Hyperuricemia is related to the clinical symptoms progress of patients with cerebrovascular disease,such as,cognitive dysfunction,dizziness,vertigo,and TIA.