TY - JOUR
T1 - Serum Urate Levels Predict Joint Space Narrowing in Non-Gout Patients With Medial Knee Osteoarthritis
AU - Krasnokutsky, Svetlana
AU - Oshinsky, Charles
AU - Attur, Mukundan
AU - Ma, Sisi
AU - Zhou, Hua
AU - Zheng, Fangfei
AU - Chen, Meng
AU - Patel, Jyoti
AU - Samuels, Jonathan
AU - Pike, Virginia C.
AU - Regatte, Ravinder
AU - Bencardino, Jenny
AU - Rybak, Leon
AU - Abramson, Steven
AU - Pillinger, Michael H.
N1 - Funding Information:
The authors thank Chio Yokose, Aaron Garza, and Rochelle Yates.
Publisher Copyright:
© 2017, American College of Rheumatology
PY - 2017/6
Y1 - 2017/6
N2 - Objective: The pathogenesis of osteoarthritis (OA) includes both mechanical and inflammatory features. Studies have implicated synovial fluid uric acid (UA) as a potential OA biomarker, possibly reflecting chondrocyte damage. Whether serum UA levels reflect/contribute to OA is unknown. We investigated whether serum UA levels predict OA progression in a non-gout knee OA population. Methods: Eighty-eight patients with medial knee OA (body mass index [BMI] <33 kg/m2) but without gout were studied. Baseline serum UA levels were measured in previously banked serum samples. At 0 and 24 months, patients underwent standardized weight-bearing fixed-flexion posteroanterior knee radiography to determine joint space width (JSW) and Kellgren/Lawrence grades. Joint space narrowing (JSN) was calculated as the change in JSW from 0 to 24 months. Twenty-seven patients underwent baseline contrast-enhanced 3T knee magnetic resonance imaging for assessment of synovial volume. Results: Serum UA levels correlated with JSN values in both univariate (r = 0.40, P < 0.01) and multivariate (r = 0.28, P = 0.01) analyses. There was a significant difference in mean JSN after dichotomization at a serum UA cut point of 6.8 mg/dl, the solubility point for serum urate, even after adjustment (JSN of 0.90 mm for a serum UA ≥6.8 mg/dl and 0.31 mm for a serum UA <6.8 mg/dl; P < 0.01). Baseline serum UA levels distinguished progressors (JSN >0.2 mm) and fast progressors (JSN >0.5 mm) from nonprogressors (JSN ≤0.0 mm) in multivariate analyses (area under the receiver operating characteristic curve 0.63 [P = 0.03] and 0.62 [P = 0.05], respectively). Serum UA levels correlated with the synovial volume (r = 0.44, P < 0.01), a possible marker of JSN, although this correlation did not persist after controlling for age, sex, and BMI (r = 0.13, P = 0.56). Conclusion: In non-gout patients with knee OA, the serum UA level predicted future JSN and may serve as a biomarker for OA progression.
AB - Objective: The pathogenesis of osteoarthritis (OA) includes both mechanical and inflammatory features. Studies have implicated synovial fluid uric acid (UA) as a potential OA biomarker, possibly reflecting chondrocyte damage. Whether serum UA levels reflect/contribute to OA is unknown. We investigated whether serum UA levels predict OA progression in a non-gout knee OA population. Methods: Eighty-eight patients with medial knee OA (body mass index [BMI] <33 kg/m2) but without gout were studied. Baseline serum UA levels were measured in previously banked serum samples. At 0 and 24 months, patients underwent standardized weight-bearing fixed-flexion posteroanterior knee radiography to determine joint space width (JSW) and Kellgren/Lawrence grades. Joint space narrowing (JSN) was calculated as the change in JSW from 0 to 24 months. Twenty-seven patients underwent baseline contrast-enhanced 3T knee magnetic resonance imaging for assessment of synovial volume. Results: Serum UA levels correlated with JSN values in both univariate (r = 0.40, P < 0.01) and multivariate (r = 0.28, P = 0.01) analyses. There was a significant difference in mean JSN after dichotomization at a serum UA cut point of 6.8 mg/dl, the solubility point for serum urate, even after adjustment (JSN of 0.90 mm for a serum UA ≥6.8 mg/dl and 0.31 mm for a serum UA <6.8 mg/dl; P < 0.01). Baseline serum UA levels distinguished progressors (JSN >0.2 mm) and fast progressors (JSN >0.5 mm) from nonprogressors (JSN ≤0.0 mm) in multivariate analyses (area under the receiver operating characteristic curve 0.63 [P = 0.03] and 0.62 [P = 0.05], respectively). Serum UA levels correlated with the synovial volume (r = 0.44, P < 0.01), a possible marker of JSN, although this correlation did not persist after controlling for age, sex, and BMI (r = 0.13, P = 0.56). Conclusion: In non-gout patients with knee OA, the serum UA level predicted future JSN and may serve as a biomarker for OA progression.
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U2 - 10.1002/art.40069
DO - 10.1002/art.40069
M3 - Article
C2 - 28217895
AN - SCOPUS:85018947879
SN - 2326-5191
VL - 69
SP - 1213
EP - 1220
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 6
ER -