High total bilirubin-to-uric acid ratio predicts poor sleep quality after acute ischemic stroke: a prospective nested case-control study

• Published in: Psychogeriatrics 2023-11, Vol.23 (6), p.897-907
• Main Authors: Geng, Dandan, Wu, Beilan, Lin, Yisi, Chen, Jiahao, Tang, Wenjie, Liu, Yuntao, He, Jincai
• Format: Article
• Language: English
• Subjects: Bilirubin; Biomarkers; Hyperlipidemia; Ischemia; Regression analysis; Sex differences; Sleep disorders; Stroke; Uric acid
• ISSN: 1346-3500; 1479-8301
• DOI: 10.1111/psyg.12992

Sleep disorders are prevalent after stroke, resulting in high recurrence rates and mortality. But the biomarkers of sleep disorders in stroke patients remain to be elucidated. This study aimed to explore the relationship between total bilirubin-to-uric acid ratio (TUR) and sleep quality after acute ischemic stroke (AIS). Three hundred twenty-six AIS patients were recruited and followed up 1 month after stroke in our study. Serum total bilirubin and uric acid levels were obtained within 24 h after admission. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality 1 month after stroke. We conducted receiver operating characteristic (ROC) curve analysis and screened the optimal biomarker to differentiate sleep disorders after stroke. Then the TUR was stratified according to the best cut-off value (0.036) of the ROC and further analysed by binary logistic regression analysis. Additionally, the interaction was used to explore the difference in its effect on post-stroke sleep quality in different subgroups. Three hundred thirty-one patients (40.2%) were considered as having poor sleep quality during the one-month follow-up. Compared to patients with good sleep, patients with poor sleep were more likely to have higher TUR (IQR), 0.05 (0.03-0.06) versus 0.03 (0.02-0.04), P