ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neuroinflammation and Neuropathy
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1542298
The association between kidney function-standardized serum uric acid levels and stroke risk: Insights from the National Health and Nutrition Examination Survey
Provisionally accepted
Xinmin Deng1*
Kunlin Kuang1Shanshan Liu1Yumei Zhong2
Rui Lai1
Xiaofeng Lv1Meijun Liu3Jingtao Liang3
Dongdong Yang3*- 1Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 2Chengdu integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, Sichuan Province, China
- 3Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
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Background: Previous studies on the relationship between serum uric acid to serum creatinine ratio (SUA/SCr) and stroke have shown inconsistent results. This study investigates the association between SUA/SCr and stroke risk using data from the National Health and Nutrition Examination Survey (NHANES). Materials and methods: A cross-sectional analysis was conducted using NHANES data from 1999 to 2018. Weighted univariate and multivariate logistic regression models were used to evaluate the association between SUA/SCr and stroke. The restricted cubic spline (RCS) curve was used to explore the nonlinear relationship between SUA/SCr and stroke risk. Results: In the regression model adjusted for all covariates, the OR (95% CI) for the association between SUA/SCr and stroke was 0.84 (0.78, 0.92), indicating a significant association between SUA/SCr and stroke risk. When SUA/SCr was analyzed as a categorical variable by quartiles, participants in the highest SUA/SCr quartile (Q4) had a 53% lower risk of stroke compared to those in the lowest quartile (Q1), with an OR (95% CI) of 0.47 (0.31, 0.71). RCS analysis revealed a nonlinear relationship between SUA/SCr and stroke risk (nonlinearity p = 0.048). Before the nonlinear inflection point (6.33), stroke risk significantly decreased as SUA/SCr increased. After this point, the decrease in stroke risk with increasing SUA/SCr slowed down markedly. Conclusion: Our study indicates that higher SUA/SCr levels are associated with a lower risk of stroke. However, further prospective longitudinal studies are required to establish the causal relationship and explore the potential role of SUA/SCr in stroke risk assessment and prevention strategies.
Keywords: Serum uric acid, serum creatinine, Stroke, NHANES, Cross-sectional study
Received: 09 Dec 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Deng, Kuang, Liu, Zhong, Lai, Lv, Liu, Liang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinmin Deng, Chengdu University of Traditional Chinese Medicine, Chengdu, China
Dongdong Yang, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
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