Xanthine oxidase (XO), a form of
xanthine oxidoreductase, is widely distributed in various human tissues. As a major source for the generation of
superoxide radicals, XO is involved in the induction of oxidative stress and
inflammation during ischemic and hypoxic tissue injury. Therefore, we designed this study to identify the role of serum XO levels in
acute ischemic stroke (AIS) pathogenesis. In this single-center prospective study, 328 consecutive patients with AIS for the first time were included, and 107 age- and sex-matched healthy controls from a community-based
stroke screening population were also included. The serum levels of XO and several conventional
stroke risk factors were assessed. Multivariate analysis was applied to evaluate the relationship between serum levels of XO and clinical outcomes, and nomogram models were developed to predict the onset, progression and prognosis of AIS. Compared with the healthy control group, the serum level of XO was significantly higher in the AIS group (P < 0.05) and was an independent risk factor for AIS (OR 8.68, 95% CI 4.62-14.33, P < 0.05). Patients with progressive
stroke or a poor prognosis had a much higher serum level of XO than patients with stable
stroke or a good prognosis (all P < 0.05). In addition, the serum level of XO was an independent risk factor for
stroke progression (OR 1.98, 95% CI 1.12-3.50, P = 0.018) and a poor prognosis (OR 2.51, 95% CI 1.47-3.31, P = 0.001). The nomogram models including XO to predict the onset, progression and prognosis of AIS had good prediction and differentiation abilities. The findings of this study show that the serum level of XO on admission was an independent risk factor for AIS and had certain clinical predictive value for
stroke progression and prognosis in patients with AIS.