Globally, the prevalence of stroke has shown an increasing trend due to the aging of the population, further population growth, and the increasing prevalence of risk factors [8]. CVHI score values from cerebrovascular hemodynamic testing are used for early assessment and management of people at risk for stroke, facilitating early detection of subjects who can be prevented. SUA has been extensively evaluated and has been proved to be an unrelated predictor not only of cardiovascular death, but also of stroke [9]. Elevated Cr is linked to an increase in patient mortality with myocardial infarction or stroke in cardiovascular disease, and therefore Cr concentration has been suggested by scholars as a possible marker of increased stroke risk [10]. Studies have pointed out that SUA/Cr in normalized renal function has become a new kind of biomarker [11]. In this study, the relationship between the SUA/Cr ratio and the CVHI score was investigated based on a population with a healthy physical examination and selected for noninvasive cerebral hemodynamic testing.
According to the findings of this study, Vmax, Vmin and Vmean were gradually decreased in Q1, Q2, Q3 and Q4 groups when comparing different SUA/Cr level groups with cerebral hemodynamic testing indexes, where the lower Vmax and minimum flow velocity Vmin were relatively higher risk of stroke, which was similar to the findings of Lina Zhang [12]. Rv, Zcv, WV, DR, CP, and DP showed a tendency to increase in the Q1, Q2, Q3, and Q4 groups, with statistically significant differences (P < 0. 001). It was shown that peripheral resistance Rv, pulse wave velocity WV and and characteristic impedance Zcv exhibit elevated changes when cerebrovascular damage occurs, and the abnormal changes in these values can be used to explain the poor blood supply status of cerebral vessels or the decrease in cerebrovascular elasticity [7]. Rv values may reflect individual risk indicators for cerebral hemorrhage, and elevated CP values may indicate cerebrovascular microcirculatory disorders [13] This suggests that abnormalities in cerebral hemodynamic parameters may be suggested by different SUA/Cr ratio levels, especially when the SUA/Cr ratio is ≥ 5.55.
In the present study, the percentage of cerebral hemodynamic scores less than 75 was 12.8%, 13.2%, 14.4%, and 18.0% (P < 0.001) in Q1, Q2, Q3, and Q4 groups, which demonstrated that the increase of SUA/Cr may lead to the slowing down of carotid blood flow, and the lower value of CVHI score indicates the corresponding impairment of cerebrovascular function. The lower the CVHI score, the lower the cerebrovascular function. The increase in SUA/Cr levels was associated with a corresponding change in CVHI values. SUA has been found to have strong antioxidant properties, it is an excellent antioxidant for the brain. [14]. Therefore, scholars have found that a lower SUA/Cr ratio when a patient is at the beginning of a stroke implies a lower antioxidant capacity, that leads to neuronal damage and can eventually impair their neurological function [11]. In contrast, the outcomes of the current study were contrary to this, so the ratio could be focused on in physical examinations and in clinical settings in the future.
Previous studies have also investigated the association of SUA/Cr ratio with clinical outcomes in certain diseases. The SUA/Cr ratio is strongly linked to the risk of metabolic syndrome and may serve as an independent predictor. [15]. Another multifactorial logistic regression outcome study of nonalcoholic fatty liver disease showed that SUA/Cr ratio was an independent risk factor [16]. The SUA/Cr ratio was significantly and positively associated with total adult mortality and cardiovascular disease mortality, according to data from the United States National Health and Nutrition Examination Survey. [17]. In this study's logit regression analysis, SUA/Cr was identified as a potential factor influencing CVHI integral value. SUA/Cr is an indirect important indicator for predicting and assessing high-risk groups for stroke because it serves as an independent risk factor for decreased CVHI score in high-risk groups for stroke (P 0.05). This study indicates that the risk of stroke may increase in high-risk groups for stroke with increased SUA/Cr levels.