POS0127 ASSOCIATION BETWEEN HYPERURICEMIA AND OSTEOARTHRITIS
Authors: E. Taskina, E. Strebkova, L. Alekseeva, N. Kashevarova, K. Telyshev, E. Sharapova, S. Anikin, F. Bibulatova, A. Lila
Journal: Annals of the Rheumatic Diseases (2021)

Background: Objectives: To evaluate the relationship of hyperuricemia (GU) with the course of knee osteoarthritis (OA) and the components of metabolic syndrome (MS). Methods: The prospective study included 107 women aged 40-75 y.o, with a reliable diagnosis of I-III Kellgren J. - Lawrence J. stage of knee OA (ACR), who signed an informed consent. The average age of patients was 59.1 ± 8.9 y.o. (from 38 to 74), the duration of the disease was 9 (4-12) years. The average values of the body mass index (BMI) corresponded to obesity (30.6 ± 5.7 kg / m2), waist circumference (WC) - 93.9 ± 12.1 cm. An individual card was filled out for each patient, including anthropometric parameters, anamnesis and clinical examination data, an assessment of knee joint pain according to VAS, and concomitant diseases. All patients underwent standard X-ray of the knee joints, DEXA scan of the lumbar spine and total hip, and laboratory examination. Results: Hyperuricemia was diagnosed in 26.2% of patients. Patients with GU had a higher BMI and WC (p&lt;0.05). X-ray examination revealed significantly larger sizes of osteophytes (p = 0.02) and smaller sizes of the medial space of the knee joint (p = 0.02), while the patients of both groups were comparable in age and duration of OA (Table 1). Patients with GU had a statistically significantly higher bone mineral density (BMD) values were observed in L1-L4 and total hip (p&lt;0.05). MS was almost 2 times more often diagnosed in patients with GU (83.3% vs. 49.2%, RR=1.71, 95%Cl 1.21-2.36, p=0.01). Higher levels of CRP, COMP, leptin, triglycerides (TG), creatinine, ALT and AST were determined in patients with GU (Table 1). Spearman rank ordered correlation coefficients between GU and BMI (r=0.22, p=0.03), WC (r=0.26, p=0.02), MS (r=0.29, p=0.01), and CHD (r=0.21, p=0.04). There were a correlation between GU and the stage of knee OA (X-ray) (r=0.34, p=0.02), the size of medial osteophytes in the femur (mm) (r=0.37, p=0.01) and the medial space of the knee joint (mm) (r=-0.27, p=0.01), BMD L1-L4 (r=0.37, p=0.03) and the total hip (r=0.37, p=0.04). There were also significant positive associations with the following laboratory parameters: CRP (r=0.27, p=0.007), COMP (r=0.25, p=0.05), leptin (r=0.29, p=0.03), creatinine (r=0.45, p&lt;0.0001), TG (r=0.44, p=0.0001), ALT (r=0.32, p=0.002), AST (r=0.25, p=0.02). Table 1. Comparative characteristics of OA patients with and without GU Parameter OA Patients with GU (n = 28) OA Patients without GU (n = 79) p Age, y.o. 61 (53-68) 60 (54-66) 0.33 Duration OA, years 10 (6-14) 7.5 (3-12) 0.06 WC, сm 99.3 ± 12.8 92.2 ± 11.4 0.02 BMI, kg/m 2 33.5 ± 5.6 30 ± 5.6 0.04 The size of the medial space of joint according to X-ray, mm 2.3 (1.2-3.3) 3.2 (2.0-4.3) 0.02 The size of the osteophytes of the femur, mm 5.8 (3.7-6.3) 2.9 (1.7-4.5) 0.02 BMI L1-L4, g/сm 2 1.18 (1.12-1.24) 1.0 (0.86-1.15) 0.04 BMI total hip, g/сm 2 1.05 (1.0-1.13) 0.9 (0.82-0.98) 0.04 CRP, mg/l 2.8 (1.9-6.2) 1.9 (1.2-3.6) 0.007 COMP, ng/ml 31.9 (27.6-45) 24.2 (18.9-38.7) 0.05 Leptin, ng/ml 46.2 (36.5-72) 30.5 (19.5-45.6) 0.03 TG, mmol/l 1.97 (1.61-2.41) 1.26 (0.87-1.63) 0.002 Creatinine, mmol/l 79 (74.9-86) 68 (62-74) 0.0001 ALT, mmol/l 26.5 (17.2-32.9) 17.9 (13.2-21.7) 0.003 АST, mmol/l 22.5 (18.5-27.8) 18.9 (16.8-21.9) 0.02 Conclusion: GU may be an aggravating predictor of not only MS-associated diseases such as obesity, dyslipidemia, but also OA. Thus, at high levels of uric acid, more advanced radiological stages of OA, high values of the BMD of the axial skeleton and increased values of CRP, COMP are noted. In this connection, therapeutic interventions of OA in patients with GU should also be aimed at reducing the concentration of uric acid, which may provide a slowdown in the progression of the disease. Further study of this issue is needed. Disclosure of Interests: None declared