1
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Cai M, Liu W, Wu Y, Zheng Q, Liu D, Shi G. The serum uric acid is longitudinally related to patients global assessment of disease activity in male patients with axial spondyloarthritis. BMC Musculoskelet Disord 2022; 23:717. [PMID: 35897055 PMCID: PMC9327298 DOI: 10.1186/s12891-022-05657-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate longitudinal relationship between serum uric acid (SUA) and disease activity among Chinese males with axial spondyloarthritis (axSpA). Methods Two-year data from the NASA study cohort of male patients with axial spondyloarthritis were analyzed. Patients global assessment of disease activity (PtGA), BASDAI, ASDAS-CRP, BASFI, and SF-36 were used as the outcomes. The autoregressive Generalized Estimation Equation (GEE) model was used to investigate the longitudinal relationship between SUA and the above outcomes. Age and gender and symptom duration were tested as effect modifiers or confounders. Results In total, 102 male axSpA patients were included, 33.3% of who were hyperuricemia at baseline. Over time,serum uric acid levels associated with the global assessment of patient global assessment of disease activity (PtGA)[P=0.041, β=-2.059,95%CI(-4.032, -0.086)], SF-36: Vitality (VT) [P=0.01, β=1.751, 95%CI (0.415,3.087)], SF-36: Social Functioning (SF)[P=0.002, β= 2.968,95%CI (1.067,4.869)]). And these relationgships were independent of age, symptom duration, baseline uric acid levels, and medication use. Conclusions In summary, SUA levels is longitudinally related to PtGA and mental health assessment. Age, gender and symptom duration do not have an impact on the relationships. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05657-3.
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Affiliation(s)
- Meimei Cai
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Wen Liu
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yuanhui Wu
- Department of Rheumatology and Clinical Immunology, Jiangxi Provincial People's Hospital Affiliated of Nanchang University, Nanchang, China
| | - Qing Zheng
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dehao Liu
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Guixiu Shi
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
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2
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Liu XZ, Tian YJ, Fan J, Liu LY. Inverted J-Shaped Association of High-Sensitivity C-Reactive Protein with the Levels of Serum Uric Acid: Cross-Sectional and Longitudinal Analyses. J Inflamm Res 2022; 15:341-344. [PMID: 35079220 PMCID: PMC8776726 DOI: 10.2147/jir.s350057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/07/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Xing Zhen Liu
- Department of Health Management, Hangzhou Aeronautical Sanatorium for Special Service of China Air Force, Hangzhou, People’s Republic of China
| | - Ya Jun Tian
- Department of Health Management, Hangzhou Aeronautical Sanatorium for Special Service of China Air Force, Hangzhou, People’s Republic of China
| | - Jie Fan
- Department of Traffic Management Engineering, Zhejiang Police College, Hangzhou, People’s Republic of China
- Correspondence: Jie Fan, Zhejiang Police College, No. 555 Binwen Road, Binjiang District, Hangzhou, People’s Republic of China, Tel +8613567198867, Fax +8657131161558, Email
| | - Lian Yong Liu
- Department of Endocrinology, Punan Hospital of Pudong New District, Shanghai, People’s Republic of China
- Lian Yong Liu, Department of Endocrinology, Punan Hospital of Pudong New District, No. 279 Linyi Road, Pudong, Shanghai, 200336, People’s Republic of China, Tel +8613564144866, Fax +862158892708, Email
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3
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Luis-Rodríguez D, Donate-Correa J, Martín-Núñez E, Ferri C, Tagua VG, Pérez Castro A, Mora-Fernández C, Navarro-González JF. Serum urate is related to subclinical inflammation in asymptomatic hyperuricaemia. Rheumatology (Oxford) 2021; 60:371-379. [PMID: 32901294 DOI: 10.1093/rheumatology/keaa425] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/17/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Asymptomatic hyperuricaemia (AHU) is associated with inflammatory disorders, including cardiovascular disease. Uric acid (UA) lowering therapies may reduce the risk of appearance or the progression of these comorbidities. In this work, we investigated the relationship between serum UA levels and inflammation in subjects with AHU. METHODS Serum levels of high-sensitivity CRP (hsCRP), TNF-α and IL-6, and mRNA expression of TNFa and IL6 in peripheral blood mononuclear cells were measured in individuals with AHU and without comorbid conditions and in a control group with similar characteristics and normal serum UA levels. Additionally, we determined the variations in the inflammatory profile in a subgroup of subjects after 6 months of treatment with allopurinol. RESULTS Subjects at higher tertiles of serum UA presented higher levels of hsCRP and increased serum and mRNA expression levels of both cytokines (P < 0.001). UA levels constituted an independent predictor of increased levels of inflammatory parameters in multiple regression models (P < 0.001) and a risk factor for the presence of a subclinical inflammation in multivariate logistic regression (P < 0.001). Allopurinol reduced UA and serum and mRNA expression of inflammatory cytokines (P < 0.001). There was a significant correlation between the variations in serum UA and the variations in serum TNF-α (P < 0.01) and IL-6 (P < 0.05), and mRNA expression of these cytokines (P < 0.05). This association remained significant and independent (P < 0.01). CONCLUSION In subjects with AHU, serum UA may be an inductor of subclinical inflammation. Therapeutic reduction of serum UA was associated with a modulation of the inflammatory profile.
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Affiliation(s)
| | | | - Ernesto Martín-Núñez
- Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife.,Escuela de Doctorado y Estudios de Posgrado, Universidad de La Laguna
| | - Carla Ferri
- Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife.,Escuela de Doctorado y Estudios de Posgrado, Universidad de La Laguna
| | - Víctor G Tagua
- Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife
| | - Atteneri Pérez Castro
- Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife.,Escuela de Doctorado y Estudios de Posgrado, Universidad de La Laguna
| | - Carmen Mora-Fernández
- Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife.,GEENDIAB, Sociedad Española de Nefrología
| | - Juan F Navarro-González
- Servicio de Nefrología Hospital, Universitario Nuestra Señora de Candelaria.,Unidad de Investigación Hospital, Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife.,GEENDIAB, Sociedad Española de Nefrología.,Instituto de Tecnologías Biomédicas, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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Pietsch DEW, Kubler P, Robinson PC. The effect of reducing systemic inflammation on serum urate. Rheumatology (Oxford) 2020; 59:3108-3109. [PMID: 32182366 DOI: 10.1093/rheumatology/keaa085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- David E W Pietsch
- Department of Rheumatology, Royal Brisbane and Women's HospitalUniversity of Queensland, Herston, QLD, Australia
| | - Paul Kubler
- Department of Rheumatology, Royal Brisbane and Women's HospitalUniversity of Queensland, Herston, QLD, Australia
| | - Philip C Robinson
- Department of Rheumatology, Royal Brisbane and Women's HospitalUniversity of Queensland, Herston, QLD, Australia.,School of Clinical Medicine, Faculty of Medicine, Royal Brisbane Hospital, University of Queensland, Herston, QLD, Australia
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Jatuworapruk K. Inpatient gout flare is multifactorial: comment on "clinical characteristics and risk factors for gout flare during the postsurgical period". Adv Rheumatol 2020; 60:44. [PMID: 32847627 DOI: 10.1186/s42358-020-00147-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kanon Jatuworapruk
- Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand.
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Abstract
OBJECTIVES To investigate the morbidity, clinical characteristics, and risk factors for postoperative recurrent gout flares (PRGFs). METHODS This cross-sectional study included all surgical patients at 2 academic institutions between 2010 and 2018. Data including demographics, prior history of gout, clinical variables, medications, and the occurrence of PRGFs were abstracted from medical records. Forward stepwise multivariable logistic regression analysis was used in the statistical analyses. RESULTS Among the 518 (0.5% [518/114,760]) surgical patients with a prior diagnosis of gout, 474 had sufficient documentation for analysis. Of these, 191 (40.3%) had experienced a PRGF. Most PRGFs (54.4%) were polyarticular gout; 79.6% had a pretreatment pain score of PRGFs ≥7, and 59.2% required combination pharmacologic therapy. The mean (SD) serum urate (SU) level decreased postoperatively (500.33 [122.77] vs. 380.15 [118.35] μmol/L; p = 0.000), with an average decrease of 125.86 μmol/L. The decrease in the postsurgical SU level was greater in patients who received postoperative total parenteral nutrition (PTPN) than in those who did not (p = 0.009), and it was correlated with the duration of PTPN (r = 0.156, p = 0.031). Factors independently associated with PRGFs were decrease in the postsurgical SU level by ≥126 μmol/L, previous flares involving the ankle, failure to take prophylactic colchicine therapy, and abdominal surgery. CONCLUSIONS Recurrent gout flares often occur postoperatively and are severe. For high-risk patients, especially those undergoing abdominal surgeries, timely monitoring of postsurgical SU level, colchicine prophylaxis, and avoiding the overuse of PTPN may help prevent PRGFs.
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Hasikova L, Pavlikova M, Hulejova H, Kozlik P, Kalikova K, Mahajan A, Herrmann M, Stiburkova B, Zavada J. Serum uric acid increases in patients with systemic autoimmune rheumatic diseases after 3 months of treatment with TNF inhibitors. Rheumatol Int 2019; 39:1749-1757. [PMID: 31363829 DOI: 10.1007/s00296-019-04394-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/22/2019] [Indexed: 02/04/2023]
Abstract
In patients with gout, the serum uric acid (SUA) is usually lower during acute gouty attacks than during intercritical periods. It has been suggested that systemic inflammatory response can cause this phenomenon. The objective is to determine whether therapy with TNF inhibitors (TNFis) affects SUA levels in patients with systemic autoimmune rheumatic diseases (SARDs) and whether SUA changes correlate with pro-inflammatory cytokines or with the oxidative stress marker allantoin. In this study, SUA, CRP, creatinine, MCP-1, IFN-α2, IFN-γ, Il-1β, IL-6, IL-8, IL-10, IL-12, IL-17a, IL-18, IL-23, IL-33, TNF-α, and allantoin levels were measured prior to and after 3 months of TNFis treatment in patients with SARDs. The values obtained in the biochemical assays were then tested for associations with the patients' demographic and disease-related data. A total of 128 patients (rheumatoid arthritis, n = 44; ankylosing spondylitis, n = 45; psoriatic arthritis, n = 23; and adults with juvenile idiopathic arthritis, n = 16) participated in this study. Among the entire patient population, SUA levels significantly increased 3 months after starting treatment with TNFis (279.5 [84.0] vs. 299.0 [102.0] μmol/l, p < 0.0001), while the levels of CRP, IL-6, IL-8, and MCP-1 significantly decreased. Male sex was the most powerful baseline predictor of ΔSUA in univariate and multivariate models. None of the measured laboratory-based parameters had statistically significant effects on the magnitude of ΔSUA. 3 months of anti-TNF therapy increased the levels of SUA in patients with SARDs, but neither the measured pro-inflammatory cytokines nor the oxidation to allantoin appeared responsible for this effect.
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Affiliation(s)
- Lenka Hasikova
- Institute of Rheumatology, Na Slupi 4, 128 50, Prague 2, Czech Republic.,Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Pavlikova
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic
| | - Hana Hulejova
- Institute of Rheumatology, Na Slupi 4, 128 50, Prague 2, Czech Republic
| | - Petr Kozlik
- Department of Analytical Chemistry, Faculty of Science, Charles University, Prague, Czech Republic
| | - Kveta Kalikova
- Department of Physical and Macromolecular Chemistry, Faculty of Science, Charles University, Prague, Czech Republic
| | - Aparna Mahajan
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Blanka Stiburkova
- Institute of Rheumatology, Na Slupi 4, 128 50, Prague 2, Czech Republic.,Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jakub Zavada
- Institute of Rheumatology, Na Slupi 4, 128 50, Prague 2, Czech Republic. .,Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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Shi X, Yang J, Wang L, Zhao M, Zhang C, He M, Qin X, Tang G, Li J, Zhang Y, Huo Y, Cai Y, Zhao G, Dong Q, Xu X, Wang B, Fu J, Wang K. Prospective study of serum uric acid levels and stroke in a Chinese hypertensive cohort. Clin Exp Hypertens 2017; 39:527-531. [PMID: 28569612 DOI: 10.1080/10641963.2017.1281938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Our aim was to investigate the association between serum uric acid (SUA) levels and the risk of first stroke in a Chinese population of hypertensive patients. This prospective study enrolled 20,577 hypertensive participants who without a history of stroke, and was conducted from May 2008 to August 2013 in Anqing and Lianyungang (China). A total of 632 (3.1%) first stroke events (510 ischemic events, 120 hemorrhagic events and 2 unspecified stroke events) were identified during a mean 4.5-year follow-up period. The risk of first stroke was not significantly associated with the increased SUA levels; this conclusion was also found after adjustment for gender and age. However, a statistically significant decreased risk of hemorrhagic stroke for the second SUA quartile (Q2) compared to the first quartile (Q1) (HR 0.56, 95%CI: 0.32-0.97, P = 0.037) was found. In addition, when grouped by tertiles of diastolic blood pressure (DBP), the results showed that high SUA lowered the risk of total stroke in participants in the third SUA quartile (Q3) (HR 0.69, 95%CI: 0.49-0.96, P = 0.028) and fourth SUA quartile (Q4) (HR 0.70, 95%CI: 0.50-0.99, P = 0.043) as compared with that in the first quartile (Q1). To sum up, no significant evidence in present study indicates that increased SUA levels are predictive of first stroke in a Chinese population of hypertensive patients.
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Affiliation(s)
- Xiuli Shi
- a Department of Neurology , First Affiliated Hospital of Anhui Medical University , Hefei 230022 , China
| | - Juan Yang
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Liwei Wang
- c School of Health Administration , Anhui University , Hefei , China
| | - Min Zhao
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Chunyan Zhang
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Mingli He
- d Department of Neurology , First People's Hospital , Lianyungang , China
| | - Xianhui Qin
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Genfu Tang
- c School of Health Administration , Anhui University , Hefei , China
| | - Jianping Li
- e Cardiology Department , Peking University First Hospital , Beijing , China
| | - Yan Zhang
- e Cardiology Department , Peking University First Hospital , Beijing , China
| | - Yong Huo
- e Cardiology Department , Peking University First Hospital , Beijing , China
| | - Yefeng Cai
- f Department of Neurology , Guangdong Provincial Hospital of Chinese Medicine , Guangzhou , China
| | - Gang Zhao
- g Department of Neurology , Xijing Hospital, Forth Military Medical University , Xi'an , China
| | - Qiang Dong
- h Department of Neurology , Huashan Hospital, Fudan University , Shanghai , China
| | - Xiping Xu
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Binyan Wang
- b National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China
| | - Jia Fu
- a Department of Neurology , First Affiliated Hospital of Anhui Medical University , Hefei 230022 , China
| | - Kai Wang
- a Department of Neurology , First Affiliated Hospital of Anhui Medical University , Hefei 230022 , China
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Dai M, Huang T, Chao L, Xie Q, Tan Y, Chen C, Meng W. Horseradish peroxidase-catalyzed polymerization of L-DOPA for mono-/bi-enzyme immobilization and amperometric biosensing of H2O2 and uric acid. Talanta 2015; 149:117-123. [PMID: 26717822 DOI: 10.1016/j.talanta.2015.11.047] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/15/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
Abstract
Horseradish peroxidase (HRP)-catalyzed polymerization of L-DOPA (vs. dopamine) in the presence of H2O2 (and uricase (UOx)) was exploited to immobilize mono-/bi-enzymes for hydroquinone-mediated amperometric biosensing of H2O2 and uric acid (UA). The relevant polymeric biocomposites (PBCs) were prepared in phosphate buffer solution containing HRP and L-DOPA (or plus UOx) after adding H2O2. The mono-/bi-enzyme amperometric biosensors were prepared simply by casting some of the PBCs on Au-plated Au (Au(plate)/Au) electrodes, followed by coating with an outer-layer chitosan (CS) film for each. UV-vis spectrophotometry, scanning electron microscopy, cyclic voltammetry and electrochemical impedance spectroscopy were used for film characterization and/or process monitoring. The HRP immobilized by enzyme catalysis well preserved its bioactivity, as confirmed by UV-vis spectrophotometry. Under optimized conditions, the monoenzyme CS/HRP-poly(L-DOPA) (PD)/Au(plate)/Au electrode potentiostated at -0.1V responded linearly to H2O2 concentration from 0.001 to 1.25mM with a sensitivity of 700μA mM(-1)cm(-2) and a limit of detection (LOD) of 0.1μM, and the bienzyme CS/UOx-HRP-PD/Au(plate)/Au electrode at -0.1V responded linearly to UA concentration from 0.001 to 0.4mM with a sensitivity of 349μA mM(-1)cm(-2) and a LOD of 0.1μM. The mono-/bi-enzyme biosensors based on biosynthesized PD performed better than many reported analogues and those based on similarly biosynthesized polydopamine.
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Affiliation(s)
- Mengzhen Dai
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Ting Huang
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Long Chao
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Qingji Xie
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China.
| | - Yueming Tan
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Chao Chen
- Key Laboratory of Chemical Biology and Traditional Chinese Medicine Research (Ministry of Education), College of Chemistry and Chemical Engineering, Hunan Normal University, Changsha 410081, PR China
| | - Wenhua Meng
- Hunan Normal University Hospital, Changsha 410081, PR China
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10
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Zhu A, Zou T, Xiong G, Zhang J. Association of uric acid with traditional inflammatory factors in stroke. Int J Neurosci 2015; 126:335-41. [PMID: 26001205 DOI: 10.3109/00207454.2015.1015723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Uric acid (UA) plays an important role in the oxidant stress that causes inflammation. We assessed the association between UA and neutrophil ratio, white blood cell (WBC) count and blood lipid in 524 patients admitted with stroke. Stroke patients with a neutrophil ratio >70% displayed significantly lower UA levels than those with a neutrophil ratio ≤70% (p < 0.05). According to UA quartiles, neutrophil ratio, WBC count, and high-density lipoprotein cholesterol in the UA grade 1 group (≤214.10 μmol/L) were significantly increased over those in other UA grade groups. The results of stepwise regression analysis found that UA levels were inversely associated with neutrophil ratios (B ± SE = -1.11 ± 0.35), high-density lipoprotein cholesterol (B ± SE = -46.18 ± 14.17), total cholesterol (B ± SE = 9.82 ± 3.66), blood urea nitrogen (B ± SE = 6.30 ± 1.73), and creatinine (B ± SE = 0.63 ± 0.10). There is a correlationship between lower serum uric acid with neutrophil ratios in inflammation associated with stroke and the reasons need to be investigated further.
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Affiliation(s)
- Aiqun Zhu
- a Nursing School of Central South University; The Second Xiangya Hospital of Central South University ; Changsha , Hunan 410013 , China
| | - Ting Zou
- b Department of Neurology, The Second Xiangya Hospital , Central South University , Changsha , Hunan 410011 , China
| | - Guangzhong Xiong
- c Department of Emergency, The Second Xiangya Hospital , Central South University , Changsha , Hunan 410011 , China
| | - Jingping Zhang
- d Nursing School of Central South University , Changsha , Hunan 410013 , China
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11
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Dhaese S, Stryckers M, Van Der Meersch H, Terryn W, Van Laecke S. Gouty arthritis of the spine in a renal transplant patient: a clinical case report: an unusual presentation of a common disorder. Medicine (Baltimore) 2015; 94:e676. [PMID: 25837758 PMCID: PMC4554016 DOI: 10.1097/md.0000000000000676] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Axial gout is a well-documented but uncommon manifestation of gout. Its mimicking nature and the impracticality of axial joint aspiration might considerably delay its diagnosis. We report a case in a normouricemic renal transplant recipient, whereby the primary symptom of severe neck pain suggested pyogenic spondylodiscitis as an initial tentative diagnosis. Clinical findings included a high C-reactive protein concentration and elevated body temperature. The patient did not respond to empiric antibiotic treatment and suffered consecutive attacks of severe wrist and ankle pain in conjunction with a persistent fever. Blood and joint cultures were negative, but analysis of aspirated ankle joint fluid revealed monosodium urate crystals. A dual-energy computed tomography scan confirmed the presence of monosodium urate crystals in the costovertebral joints. Colchicine treatment dramatically improved the patient's clinical condition. Axial gout should be considered in transplant recipients with severe neck or back pain, fever, and increased inflammatory parameters with a high likelihood of an infectious etiology, despite the presence of paradoxically normal or even decreased serum urate concentrations. Dual-energy computed tomography is a noninvasive technique of possible benefit in the detection of axial gout when joint fluid aspiration is not deemed safe.
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Affiliation(s)
- Sofie Dhaese
- From the Renal Division, Department of Internal Medicine (SD, MS, HVDM, SVL), Ghent University Hospital, Ghent, and Department of Nephrology and General Internal Medicine, Jan Yperman Hospital (WT), Ypres, Belgium
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13
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Wang W, Qin C, Xie Q, Qin X, Chao L, Huang Y, Dai M, Chen C, Huang J, Hu J. Rapid electrodeposition of a gold–Prussian blue nanocomposite with ultrahigh electroactivity for dual-potential amperometric biosensing of uric acid. Analyst 2014; 139:2904-11. [DOI: 10.1039/c3an02390g] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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14
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Cottrell E, Crabtree V, Edwards JJ, Roddy E. Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice. BMC FAMILY PRACTICE 2013; 14:170. [PMID: 24225170 PMCID: PMC3830984 DOI: 10.1186/1471-2296-14-170] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 11/11/2013] [Indexed: 01/30/2023]
Abstract
Background Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the European League Against Rheumatism (EULAR) have published guidance regarding the management of gout, thereby providing standards against which performance can be measured. This audit was designed to assess the extent to which patients diagnosed with gout in one primary care medical practice in North Staffordshire, UK, are managed in accordance with current best practice guidelines, and to identify strategies for improvement where appropriate. Methods Audit criteria were derived from the EULAR and BSR/BHPR guidelines; standards were set arbitrarily, but with consideration of patient comorbidity and other factors which may influence concordance. An electronic search of the practice records was performed to identify adults with a diagnosis of gout. Medical record review with a descriptive analysis was undertaken to assess the extent to which medical management adhered to the predefined standards. Results Of the total ≥18 year-old practice population (n = 8686), 305 (3%) patient records included a diagnosis of gout. Of these, 74% (n = 226) had an electronic record of serum uric acid (SUA), and 11% (n = 34) and 53% (n = 162) a measure of estimated glomerular filtration rate (eGFR) ever and serum glucose since diagnosis respectively. 34% (n = 105) of patients had ever taken urate-lowering therapy with 25% (n = 77) currently prescribed this at the time of data extraction. Dose adjustment and monitoring of treatment according to SUA was found to be inadequate. Provision of lifestyle advice and consideration of comorbidities was also lacking. Conclusions The primary care management of gout in this practice was not concordant with national and international guidance, a finding consistent with previous studies. This demonstrates that the provision of guidelines alone is not sufficient to improve the quality of gout management and we identify possible strategies to increase guideline adherence.
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Affiliation(s)
- Elizabeth Cottrell
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, ST5 5BG, Staffordshire.
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