Urinary ketone bodies and stroke recurrence in patient with acute ischemic stroke or TIA

Liye Dai; Anxin Wang; Hongqiu Gu; Yijun Zhang; Yingting Zuo; Xia Meng; Pan Chen; Xue Tian; Hao Li; Yongjun Wang

doi:10.1016/j.jocn.2023.09.019

Urinary ketone bodies and stroke recurrence in patient with acute ischemic stroke or TIA

J Clin Neurosci. 2023 Nov:117:79-83. doi: 10.1016/j.jocn.2023.09.019. Epub 2023 Sep 29.

Authors

Liye Dai¹, Anxin Wang², Hongqiu Gu², Yijun Zhang², Yingting Zuo³, Xia Meng², Pan Chen², Xue Tian³, Hao Li², Yongjun Wang⁴

Affiliations

¹ Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
⁴ China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: yongjunwang@ncrcnd.org.cn.

PMID: 37778303
DOI: 10.1016/j.jocn.2023.09.019

Abstract

Background: Urine ketone bodies may appear in different states in the acute stage of stroke. We aimed to examine the association between urine ketone bodies and recurrent stroke in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) in this study.

Methods: In Third China National Stroke Registry (CNSR-III), 14,015 patients with AIS or TIA were screened for urine ketone bodies. The outcomes were any stroke, ischemic stroke and combined vascular events within 1 year. The association of urine ketone bodies with recurrent stroke were analyzed by Cox proportional hazards.

Results: During 1 year of follow-up, 1,335 (9.53%) participants experienced recurrent stroke. After adjustment for conventional confounding factors, patients with urine ketone bodies test positive had a higher risk of recurrent stroke (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.13-1.82), compared to those were negative. The correlation between positive urine ketone bodies and recurrent stroke were consistent in patient with (HR, 1.45; 95% CI, 1.00-2.12) and without (HR, 1.40; 95% CI, 1.02-1.94) diabetes. No significant interaction between urine ketone bodies and diabetes were observed.

Conclusions: Positive ketone bodies in urine was independently associated with recurrent stroke in patients with AIS or TIA.

Keywords: Diabetes; Stroke; TIA; Urine ketone bodies.

MeSH terms

Cerebral Infarction
Diabetes Mellitus*
Humans
Ischemic Attack, Transient* / complications
Ischemic Attack, Transient* / diagnosis
Ischemic Stroke*
Ketone Bodies
Recurrence
Risk Factors
Stroke* / complications
Stroke* / diagnosis

Substances

Ketone Bodies