POS0477 THE IMPACT OF SERUM URIC ACID ON ALL-CAUSE MORTALITY IN RHEUMATOID ARTHRITIS PATIENTS
Authors: L MI, Q. H LI, L. Dai
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease primarily presenting as synovitis and potentially reduced life expectancy. While serum urate (sUA) is recognized as a critical metabolic end product and a known risk factor for mortality, its specific impact on mortality in RA patients remains insufficiently elucidated due to limited studies. <h3>Objectives:</h3> This study aims to explore the correlation between sUA levels and all-cause mortality among RA patients, filling a notable gap in current rheumatological research. <h3>Methods:</h3> We conducted a comprehensive analysis of data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. A total of 2952 RA patients were initially selected. The study involved stratifying patients into four groups based on sUA levels: &lt;4mg/dl, 4-6mg/dl, 6-8mg/dl, and &gt;8mg/dl. Cox proportional hazards models, segregated by gender, assessed the relationship between sUA levels and all-cause mortality. Furthermore, a restricted cubic spline (RCS) model was employed to delve into the nuances of the sUA-all-cause mortality relationship, adjusting for variables including age, sex, race, educational level, chronic kidney disease (CKD), coronary heart disease, diabetes mellitus (DM), hyperlipidemia, hypertension, smoking, and alcohol consumption. <h3>Results:</h3> Following the exclusion of 339 patients due to incomplete data, 2612 participants were included in the final analysis, comprising 1075 males (41.2%) and 1537 females (58.8%). The average sUA level was 5.6 ± 1.6mg/dl, with men averaging at 6.2 ± 1.5mg/dl and women at 5.2 ± 1.6mg/dl. The mean follow-up duration was 107.2 ± 66.0 months. The study observed 784 all-cause deaths, with 231 attributed to cardiovascular diseases. Kaplan-Meier analysis revealed the highest mortality in the &gt;8mg/dl sUA group across all patients (p&lt;0.001) and within gender-specific analyses. Cox analysis indicated a positive correlation between sUA levels and all-cause mortality in the entire cohort and when stratified by sex. The Cox regression analysis revealed that the HR for the group with sUA levels greater than 8 mg/dl, as compared to those with levels less than 4 mg/dl, is 1.8 (95%CI: 1.2 to 2.5) for the entire patient cohort. Specifically, the HR is 1.8 (95% CI: 1.1 to 3.1) in male patients and 2.0 (95% CI: 1.2 to 3.2) in female patients.The RCS model reinforced these findings, underscoring the linear relationship between sUA concentrations and mortality risk, post-adjustment. <h3>Conclusion:</h3> Our study demonstrates a significant positive association between elevated sUA levels and all-cause mortality in RA patients. The mortality risk was notably higher in patients with sUA levels exceeding 8mg/dl. These findings suggest that sUA could be a crucial factor in assessing health outcomes of patients with rheumatoid arthritis. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>