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Zhao J, Sha B, Zeng L, Dou Y, Huang H, Liang G, Pan J, Hong K, Zhou G, Yang W, Liu J. J-shaped association of serum uric acid concentrations with all-cause mortality in individuals with osteoarthritis: A prospective cohort study. Joint Bone Spine 2024; 91:105679. [PMID: 38143017 DOI: 10.1016/j.jbspin.2023.105679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA). METHODS All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality. RESULTS During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6mg/dl and 6.2mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively. CONCLUSIONS There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6mg/dl and 6.2mg/dl, respectively.
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Affiliation(s)
- Jinlong Zhao
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Bangxin Sha
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Lingfeng Zeng
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Yaoxing Dou
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Hetao Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China
| | - Guihong Liang
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China; The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China
| | - Jianke Pan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China
| | - Kunhao Hong
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; Guangdong Second Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), 510095 Guangzhou, China
| | - Guanghui Zhou
- The Second Clinical College/State Key Laboratory of Traditional Chinese Medicine Syndrome of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Weiyi Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), 510120 Guangzhou, China.
| | - Jun Liu
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, 510120 Guangzhou, China; The Fifth Clinical College of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China; Guangdong Second Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), 510095 Guangzhou, China.
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Gao R, Pu J, Wu Z, Tang J, Wang X. Osteoarthritis or arthritis? Toward understanding of primary Sjögren's syndrome patients with arthralgia. J Orthop Surg Res 2023; 18:41. [PMID: 36647153 PMCID: PMC9841668 DOI: 10.1186/s13018-023-03513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/07/2023] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To identify primary Sjögren's syndrome (pSS) patients with arthralgia at risk for osteoarthritis (OA) or arthritis. METHODS This study included 368 pSS patients admitted to a mono-centric from March 2010 to December 2020. Patients were divided into groups according to whether complicated with OA or arthritis. Data were analyzed to determine the differences in demographical characteristics, symptoms, and laboratory examination. RESULTS The involvement of the OA joints was predominately knee and spine sites (including cervical and lumbar spine degeneration). When diagnosing arthritis, it was mainly peripheral symmetric polyarthritis, the most affected sites were the interphalangeal and metacarpophalangeal joints. There were significant differences in age, disease duration, uric acid (UA), and total cholesterol (TC) between pSS-OA and pSS-nOA patients (P < 0.050). Logistic regression analysis showed that age (OR = 1.965; P = 0.009) and joint pain (OR = 3.382; P < 0.001) were dangerous factors associated with OA. Interestingly, although the level of UA, TC, and triglycerides (TG) was shown to be positive with OA, there was no statistical significance after the OR was computed in the four-cell table. In pSS-arthritis, EULAR Sjögren's syndrome disease activity index (ESSDAI) (P = 0.011), the frequency of joint pain (P < 0.001), and muscular involvement (P = 0.037) were higher than non-arthritis group. In pSS patients only presenting with joint pain, arthritis patients had higher ESSDAI and system involvements, but lower UA and TG levels compared with OA group (P < 0.050). CONCLUSION In pSS patients with arthralgia, OA accounted for the majority. pSS patients with advanced age and more pronounced metabolic characteristics, such as elevated blood lipids and uric acid, was a key factor in groups at risk for OA. However, arthritis patients had higher rates of dry mouth and eye, higher disease activity, antibodies positive, and more organs damage. In the future, it may be necessary to be more cautious in the diagnosis of joint manifestations in pSS patients in order to make the appropriate treatments.
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Affiliation(s)
- Ronglin Gao
- grid.24516.340000000123704535Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai, 200065 China
| | - Jincheng Pu
- grid.24516.340000000123704535Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai, 200065 China
| | - Zhenzhen Wu
- grid.24516.340000000123704535Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai, 200065 China
| | - Jianping Tang
- grid.24516.340000000123704535Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai, 200065 China
| | - Xuan Wang
- grid.24516.340000000123704535Department of Rheumatology and Immunology, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai, 200065 China
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Go DJ, Kim DH, Kim JY, Guermazi A, Crema MD, Hunter DJ, Kim HA. Serum uric acid and knee osteoarthritis in community residents without gout: a longitudinal study. Rheumatology (Oxford) 2021; 60:4581-4590. [PMID: 33493331 DOI: 10.1093/rheumatology/keab048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/26/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Emerging evidence suggests a potential link between OA and gout; however, the association between serum uric acid (UA) itself and knee OA remains uncertain due to a lack of longitudinal studies. Here, we investigated the association between serum UA and knee OA according to cartilage status in elderly community residents without gout. METHODS In this longitudinal study, participants without a history of gout were recruited from among the Korean cohort of the Hallym Aging Study (n = 296 for radiography study and n = 223 for MRI study). Weight-bearing knee radiographs and 1.5-T MRI scans, along with blood collection for analysis of serum UA, were performed at baseline and after 3 years. The severity and structural progression of knee OA were evaluated using the Kellgren-Lawrence grading system and the Whole-Organ MRI Score (WORMS) cartilage scoring method. Multivariable logistic regression analysis was conducted using generalized estimating equation (GEE) models. RESULTS Serum UA levels were not associated with radiographic progression after adjusting for age, sex and BMI. There was no significant association between serum UA and tibiofemoral cartilage loss on MRI. However, baseline serum UA levels were negatively associated with patellofemoral cartilage loss over 3 years (adjusted odd ratio 0.70 per 1 mg/dl increase, 95% CI: 0.49, 0.98). CONCLUSION In this population-based cohort, serum UA was not a risk factor for knee OA progression. Further large-scale longitudinal studies in other populations are needed to validate the effects of UA on cartilage damage.
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Affiliation(s)
- Dong Jin Go
- Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon
| | - Jie Young Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang.,Institute for Skeletal Aging, Hallym University, Chuncheon, Republic of Korea
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Michel Daoud Crema
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, Australia
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang.,Institute for Skeletal Aging, Hallym University, Chuncheon, Republic of Korea
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Bassiouni SARAK, El Adalany MA, Abdelsalam M, Gharbia OM. Association of serum uric acid with clinical and radiological severity of knee osteoarthritis in non-gouty patients. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-020-00055-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Abstract
Background
A growing body of evidence suggested that uric acid (UA) may contribute in the pathways underlying osteoarthritis (OA) pathogenesis; however, studies that investigated the relationship between UA and OA emerged inconclusive results. The purpose of the study was to explore the association of serum uric acid (sUA) levels with clinical severity, radiological severity of knee osteoarthritis (KOA) based on Kellgren-Lawrence (KL) grading system, and MRI changes in non-gouty patients.
Results
WOMAC scores: pain, stiffness, function, and total score are significantly higher in H-sUA group than L-sUA group (p = 0.004, p = 0.019, p = 0.018, p = 0.008 respectively). Joint space width (JSW) is significantly narrower in H-sUA group than L-sUA group (p = 0.013). H-sUA group had more frequent KL grade 4 (p < 0.001), osteophytes grade 4 (p < 0.001), focal bone erosion (p < 0.001), bone marrow lesions (p = 0.023), and synovitis (p = 0.011) than L-sUA group. Female KOA patients in H-sUA group had significantly higher pain, stiffness, and function and total WOMAC scores than L-sUA group (p = 0.003, p = 0.015, p = 0.008, p = 0.004), more frequently had KL grade 4 and osteophytes grade 4 (p = 0.003, p < 0.001), significantly narrower JSW (p = 0.016), more frequently show focal bone erosion (p = 0.002), bone marrow lesions (p = 0.019), and synovitis (p = 0.004) than L-sUA group. In regression analysis, female sex (p = 0.035), duration of KOA (p = 0.031), and sUA level (p = 0.025) were associated with KL severity. For female patients with KOA, KL severity is associated with duration of KOA (p = 0.045) and sUA (p = 0.009).
Conclusion
Higher sUA level is associated with higher clinical severity, higher radiographic KL grades, and more frequent MRI findings in patients with primary KOA patients. Our results also indicated that sUA level was significantly associated with KOA severity in female patients, but not in male patients. More studies are warranted to explore whether the two conditions exist simultaneously or there is a direct causal relationship between the two conditions.
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Osteoarthritis year in review 2019: biomarkers (biochemical markers). Osteoarthritis Cartilage 2020; 28:296-315. [PMID: 31887390 DOI: 10.1016/j.joca.2019.11.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To provide an insightful summary of studies on biochemical markers for osteoarthritis (OA). DESIGN Two investigators systematically searched the electronic PubMed database for clinical studies into soluble biochemical markers for OA in humans that were published between 01-03-2018 and 01-03-2019. Data from selected publications were systematically extracted and tabulated and were summarized in a narrative review. RESULTS Out of 1,279 publications, 124 fulfilled all selection criteria and were selected for data extraction. The majority were around knee OA, cross-sectional in design, relatively small, and/or focused on one or a few biochemical markers. Among the intervention studies, relatively many were on non-pharmacological interventions, used clinical outcomes and/or were rather short. Some leads that were provided by this year's studies pertained to less conventional inflammatory mediators, oxidative stress, acidosis, angiogenesis and/or autoantibody formation. CONCLUSIONS This year's biochemical marker studies did provide potential leads for therapeutic targets or other biochemical marker applications that require robust and strategic follow-up research to be validated.
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Kim SK, Choe JY. Association between smoking and serum uric acid in Korean population: Data from the seventh Korea national health and nutrition examination survey 2016. Medicine (Baltimore) 2019; 98:e14507. [PMID: 30762781 PMCID: PMC6407981 DOI: 10.1097/md.0000000000014507] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The aim of this study was to identify any association between serum uric acid and smoking status using data from the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1) 2016 of the Korean population.This study used a cross-sectional design and analyzed 5609 subjects aged ≥ 19 years among 8150 participants enrolled in the KNHANES VII-1 2016. Smoking status was classified into current smokers, never smokers, and ex-smokers. Hyperuricemia was defined as > 7.0 mg/dL for men and > 6.0 mg/dL of serum uric acid for women. Association between smoking and serum uric acid/hyperuricemia was assessed by Pearson's or Spearman's correlation analyses and multivariate logistic regression analysis showing odds ratio (OR) and 95% confidence interval (CI).A significant difference in serum uric acid according to smoking status was identified in female (P < .001) but not in male subjects (P = .069). In female subjects, current smokers and ex-smokers showed higher serum uric acid than never smokers (P < 0.001 of both). Serum uric acid was associated with smoking status in female but not male subjects (r = 0.057, P = .001 and r = 0.025, P = .220, respectively). There was significant difference of smoking status between female subjects with and without hyperuricemia (P < .001). Current smokers had 2.7 times higher likely to have hyperuricemia in female, compared to never smokers (OR 2.674, 95% CI 1.578 - 4.531, P < .001).This study revealed that smoking was closely associated with serum uric acid in female but not in male subjects in Korean population.
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