Sex-dependent effects of uric acid on cerebral microbleed: a cross-sectional study in the general population

Abstract

Background and purpose: Elevated serum uric acid (UA) is known to be associated with stroke. However, there is little information on the association between serum UA levels and cerebral microbleed (CMB), a precursor of stroke. Therefore, we investigated the association between UA and CMB in a general population taking into consideration sex-related differences.

Methods: The subjects in this cross-sectional study consisted of 2686 individuals of 40-79 years of age (1403 men and 1283 women) who underwent regular health screenings, including brain magnetic resonance imaging, at Seoul National University Hospital Health Promotion Center. Subjects were categorized into three groups according to tertiles of UA levels by sex. The presence and location of CMB were assessed by gradient-recalled echo magnetic resonance imaging.

Results: The prevalence of CMB was 3.8%. In multivariate logistic regression analysis by sex, the highest tertile of UA in male subjects was independently associated with the presence of CMB compared with the lowest tertile of UA (adjusted odds ratio, 2.46; P = 0.013). Meanwhile, the highest tertile of UA in female subjects was inversely associated with CMB compared with the lowest tertile of UA (adjusted odds ratio, 0.39; P = 0.040).

Conclusions: High serum UA value was associated with higher prevalence of CMB in male, but lower prevalence of CMB in female subjects.

Keywords: cerebral microbleed; cerebral small vessel disease; sex-specific; uric acid.