Moderate elevation of serum uric acid levels improves short-term functional outcomes of ischemic stroke in patients with type 2 diabetes mellitus

BACKGROUND: Serum uric acid (SUA), an end-product of purine catabolism diffused in the blood, is positively associated with the risk of type 2 diabetes mellitus (T2DM). However, in the T2DM population, the association of SUA fluctuation ([Formula: see text] SUA) with the functional outcome of ischemic stroke (IS) is still unclear. Accordingly, this study aimed to assess the correlation between [Formula: see text] SUA and short-term IS functional outcomes in T2DM patients. METHODS: All T2DM patients diagnosed with IS in the China National Stroke Registry III were included. [Formula: see text] SUA, which was defined as the difference between the SUA levels at baseline and 3 months after symptom onset, was classified into two groups, i.e., elevated [Formula: see text] SUA ([Formula: see text] SUA > 0) and reduced [Formula: see text] SUA ([Formula: see text] SUA [Formula: see text] 0). The outcomes measured using the Modified Rankin Scale (mRS) were scored from 0 to 6, and poor functional outcome was defined as an mRS score of 3–6 at 3 months after IS. RESULTS: Among the 1255 participants (mean age: 61.6 ± 9.8 years), 64.9% were men. Patients with elevated [Formula: see text] SUA had a lower incidence of poor functional outcomes at 3 months. Compared with reduced [Formula: see text] SUA, elevated [Formula: see text] SUA at 0–50 μmol/L (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.28–0.78, p = 0.004) and 50–100 μmol/L (OR = 0.40, 95% CI = 0.21–0.77, p = 0.006) was significantly correlated with a reduced risk of poor functional outcomes at 3 months. CONCLUSION: This study showed that a moderate increase in [Formula: see text] SUA in the range of 0–100 μmol/L at 3 months after IS might be beneficial in T2DM adults and more studies are warranted to confirm this. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04141-4.