STROKE
RISK FACTORS

u NON-INSULIN-DEPENDENT DIABETES MELLITUS

SERUM URIC ACID, A STRONG PREDICTOR OF STROKE
Subjects with non-insulin-dependent diabetes mellitus (NIDDM) have a twofold to fourfold greater risk of all manifestations of atherosclerotic vascular disease, including stroke, compared with nondiabetic subjects.
1017 patients with NIDDM, aged 45 to 64 years, were followed up for 7 years.
During the follow-up period, 31 patients died from stroke and 114 patients had a fatal or nonfatal stroke.
Hyperuricemia (> 295 m mol/L) increased the risk of stroke by approximately twofold.
The mechanism via which hyperuricemia is associated with atherosclerosis vascular disease is unknown.

[Lehto S. et al., Stroke 1998; 29: 635-639]

• Hypothesis
  Uric acid is one of the major endogenous water-soluble antioxidants of the body.
  High circulating uric acid levels may be an indicator that the body is trying to protect itself from the deleterious effects of free radicals by increasing the products of endogenous antioxidants.
  Uric acid prevents oxidative modification of endothelial enzymes and preserves the ability of endothelium to mediate vascular dilatation in the face of oxidative stress.
  
  Becker BF "Towards the physiological function of uric acid". Free Radic Biol Med 1993; 14: 615-631

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