The effect of uric acid on sleep quality after acute ischemic stroke.

Sleep disturbance is a common psychiatric complication after stroke. Oxidative stress has been an important pathophysiological mechanism of sleep disturbance. However, no study has explored the relationship between uric acid (UA) and post-stroke sleep quality. This prospective study included 191 patients who were followed up for two months after acute ischemic stroke. Serum UA levels were measured at admission and divided into 3 tertiles (≤251 µmol/L, 252-326 µmol/L, ≥327 µmol/L). Patients in the 3rd tertile of UA levels had a lower incidence of poor sleep quality than those belonging to 2nd or 1st tertile, respectively (9.7% vs. 27.7% vs. 35.9%; P = 0.002). Furthermore, high UA levels (≥327 µmol/L) were independently associated with low risk of poor sleep quality (OR = 0.129, 95%CI = 0.031-0.528, P = 0.004) after adjusting for demographics, cardiovascular risk factors, stroke severity, functional outcome and depressive symptoms. High modified Rankin Scale score and depressive symptoms were associated with increased risk of poor sleep quality after stroke (OR = 1.836, 95%CI = 1.035-3.354, P = 0.038) and (OR = 5.082, 95%CI = 1.709-15.115, P = 0.003). In conclusion, high UA levels may reduce the risk of poor sleep quality after acute ischemic stroke. Further randomized controlled trials are necessary in examining whether appropriate UA supplement could provide a potential prevention or therapeutic target for sleep disturbance after stroke.

High platelet-to-lymphocyte ratio are associated with post-stroke depression.

BACKGROUND: Post-stroke depression (PSD) is the most common psychological consequence among stroke patients, and inflammatory cytokines have cited as risk factors in PSD. We aimed to evaluate the predictive value of stratification of PLR (platelet-to-lymphocyte ratio), an inflammatory marker, in PSD patients. METHODS: A total of 363 acute ischemic stroke (AIS) patients were screened in the study and received 1-month follow-up. All of the patients were categorized into equal tertiles according to the number of patients and the distribution of PLR. PSD status was evaluated by 17-item Hamilton Depression Rating Scale at 1 month after stroke RESULTS: The optimal cut-off points of PLR were: (T1) 42.15-99.60, (T2) 99.72-127.92, (T3) 127.93-259.84. A total of 77 patients (21.2%) were diagnosed with PSD at 1-month follow-up. Significant differences were found between the PSD and non-PSD groups in PLR tertiles of patients (P < 0.001). After adjustment for conventional confounding factors, the odds ratio of PSD was 5.154 (95% CI, 1.933-13.739) for the highest tertile of PLR compared with the lowest tertile. In multiple-adjusted spline regression, continuously PLR showed linear relation with PSD risk after 95 (P < 0.001 for linearity). LIMITATIONS: We excluded patients with severe aphasia or serious conditions. In addition, the PLR was recorded only at admission, which limited us explore the correlation of the change of PLR over time with PSD CONCLUSIONS: Increased PLR at admission is a significant and independent biomarker to predict the development of PSD, and stratified PLR could strengthen the predictive power for PSD patients.