The effect of asymptomatic hyperuricemia on the frequency and structure of comorbidity patients with rheumatoid arthritis


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Abstract

Currently, the negative role of asymptomatic hyperuricemia (HU) in the development and progression of cardiovascular pathology, metabolic disorders and chronic kidney disease is generally recognized. At the same time, there are few data in the literature on the effect of HU on the course of comorbid pathology (CP) in patients with rheumatoid arthritis (RA). The aim of the study was to study the effect of HU on the frequency and structure of CP in patients with RA. Material and methods. The data of 262 patients with RA and HU and 262 with RA without HU (comparison group) included in the City Register from January 2000 to April 2020 were analyzed. Information was entered on demographic characteristics (gender, age), diagnosis, presence and duration of HU, presence of CP and CP therapy. HU was understood as a recorded increase in the level of uric acid (UA) in the blood serum >360 mmol/l by И time. Results. The data of 524 patients (440 women and 84 men, the average age 60,0±13,6 years) with RA for the period from January 2000 to April 2020 were analyzed. Patients with HU were divided into two subgroups: the first - the level of UA less than 500 mmol/l, the second - the level of UA more than 500 mmol/l. Patients with HU had a high incidence of arterial hypertension (84,21, 80,91 and 51,14 %), atrial fibrillation/flutter (9,21, 8,18 and 4,19 %), chronic heart failure of functional class I-III (23,68, 20 and 8,78 %), hypercholesterolemia (62,5, 67,27 and 34,4 %), prediabetes (18,42, 17,27 and 4,96 %), type 2 diabetes mellitus (25, 25,45 and 11,45 %), obesity of 1-3 degrees (32,89, 22,73 and 4,96 %), cholelithiasis (24,34, 21,82 and 11,07 %), non-alcoholic fatty liver disease (23,03, 23,64 and 6,49 %), urolithiasis (14,47, 16,36 and 8,78 %), kidney cysts (17,76, 20 and 9,16%), chronic kidney disease of stages 1-4 (58,55, 57,27 and 35,5 %) in comparison with patients without HU (p <0,05). Conclusions. 1) HU in patients with RA is associated with a higher frequency of cardiovascular diseases, metabolic disorders and chronic kidney disease. 2) Arterial hypertension (84%), hypercholesterolemia (62%) and chronic kidney disease (58%) were most often detected.

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About the authors

Vadim I. Mazurov

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: maz.nwgmu@yandex.ru
Dr. med. habil., professor, academician of RAS, chief scientific consultant, director of the Research Institute of Rheumatology, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Inna Z. Gaydukova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: ubp1976@list.ru
Dr. med. habil., deputy director of the Research Institute of Rheumatology, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Alexandra Yu. Tsinzerling

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: aleksa.fonturenko@mail.ru
rheumatologist at the Clinical Rheumatology Hospital No. 25, senior laboratory assistant/ applicant of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Roman A. Bashkinov

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: bashkinov-roman@mail.ru
postgraduate student of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Oksana V. Inamova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: b25@zdrav.spb.ru
PhD in Medicine, chief physician of the Clinical Rheumatology Hospital No. 25, deputy director of the Research Institute of Rheumatology, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Marianna S. Petrova

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25

Email: podagra@bk.ru
PhD in Medicine, deputy chief physician of the Clinical Rheumatology Hospital No. 25, head of Saint Petersburg City Clinical Center for Gout, associate professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

References

  1. Cockel R., Kendall M.J., Becker J.F., Hawkins C.F. Serum biochemical values in rheumatoid disease. Ann Rheum Dis. 1971; 30(2): 166-70. https://dx.doi.org/10.1136/ard.30.2.166.
  2. Panoulas V.F., Douglas K.M.J., Milionis H.J. et al. Serum uric acid is independently associated with hypertension in patients with rheumatoid arthritis. J. Hum Hypertens. 2008; 22(3): 177-82. https://dx.doi.org/10.1038/sj.jhh.1002298.
  3. Daoussis D., Panoulas V., Toms T. et al. Uric acid is a strong independent predictor of renal dysfunction in patients with rheumatoid arthritis. Arthritis Res Ther. 2009; 11(4): R116. https://dx.doi.org/10.1186/ar2775.
  4. Sari I., Akar S., Pakoz B. et al. Hyperuricemia and its related factors in an urban population, Izmir, Turkey. Rheumatol Int. 2009; 29(8): 869-74. https://dx.doi.org/10.1007/s00296-008-0806-2.
  5. Mishra R., Singh A., Chandra V. et al. A comparative analysis of serological parameters and oxidative stress in osteoarthritis and rheumatoid arthritis. Rheumatol Int. 2012; 32(8): 2377-82. https://dx.doi.org/10.1007/s00296-011-1964-1.
  6. Contreras-Haro B., Hernandez-Gonzalez S.O., Gonzalez-Lopez L. et al. Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus. Diabetol Metab Syndr. 2019; 11: 95. https://dx.doi.org/10.1186/s13098-019-0495-x.
  7. Santos M.J., Vinagre F., Silva J.J. et al. Cardiovascular risk profile in systemic lupus erythematosus and rheumatoid arthritis: a comparative study of female patients. Acta Reumatol Port. 2010; 35(3): 325-32.
  8. Qu B., Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound. 2015; 13: 46. https://dx.doi.org/10.1186/s12947-015-0041-4.
  9. Hannawi S., Hannawi H., Alokaily F., Al Salmi I. Variables associated with subclinical atherosclerosis among rheumatoid arthritis patients of Gulf Cooperative Council countries. Saudi Med J. 2020; 41(2): 128-37. https://dx.doi.org/10.15537/smj.2020.2.24900.
  10. Ursini F., Russo E., D'Angelo S. et al. Prevalence of undiagnosed diabetes in rheumatoid arthritis: An OGTT study. Medicine (Baltimore). 2016; 95(7): e2552. https://dx.doi.org/10.1097/MD.0000000000002552.
  11. Chavan V.U., Ramavataram D., Patel P.A., Rupani M.P. Evaluation of serum magnesium, lipid profile and various biochemical parameters as risk factors of cardiovascular diseases in patients with rheumatoid arthritis. J. Clin Diagn Res. 2015; 9(4): BC01-5. https://dx.doi.org/10.7860/JCDR/2015/12206.5740.
  12. Daoussis D., Panoulas V.F., Antonopoulos I. et al. Cardiovascular risk factors and not disease activity, severity or therapy associate with renal dysfunction in patients with rheumatoid arthritis. Ann Rheum Dis. 2010; 69(3): 517-21. https://dx.doi.org/10.1136/ard.2008.105049.
  13. Daoussis D., Kitas G.D. Uric acid and cardiovascular risk in rheumatoid arthritis. Rheumatology (Oxford). 2011; 50(8): 1354-55. https://dx.doi.org/10.1093/rheumatology/keq388.
  14. Kuo D., Crowson C.S., Gabriel S.E., Matteso E.L. Hyperuricemia and incident cardiovascular disease and noncardiac vascular events in patients with rheumatoid arthritis. Int J. Rheumatol. 2014; 2014: 523897. https://dx.doi.org/10.1155/2014/523897.
  15. Meek I.L., Vonkeman H.E., van de Laar M.A. Hyperuricaemia: A marker of increased cardiovascular risk in rheumatic patients: Analysis of the ACT-CVD cohort. BMC Musculoskelet Disord. 2014; 15: 174. https://dx.doi.org/10.1186/1471-2474-15-174.
  16. Мазуров В.И., Башкинов Р.А., Фонтуренко А.Ю. с соавт. Особенности течения ревматоидного артрита и остеоартрита у пациентов с бессимптомной гиперурикемией. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2020; 3: 63-72. https://dx.doi.org/10.17816/mechnikov44234. EDN: XQZWVY.
  17. Zaragoza-Garcia O., Navarro-Zarza J.E., Maldonado-Anicacio J.Y. et al. Hypertriglyceridaemic waist is associated with hyperuricaemia and metabolic syndrome in rheumatoid arthritis patients. Diabetes Metab Syndr. 2019; 13(1): 722-29. https://dx.doi.org/10.1016/j.dsx.2018.11.053.
  18. Chandrashekara S., Dhote S.V., Anupama K.R. The differential influence of immunological process of autoimmune disease on lipid metabolism: A study on RA and SLE. Indian J. Clin Biochem. 2019; 34(1): 52-59. https://dx.doi.org/10.1007/s12291-017-0715-9.
  19. Crowson C.S., Myasoedova E., Davis J.M. 3rd et al. Increased prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease. J. Rheumatol. 2011; 38(1): 29-35. https://dx.doi.org/10.3899/jrheum.100346.
  20. Panoulas V.F., Toms T.E., Metsios G.S. et al. Target organ damage in patients with rheumatoid arthritis: The role of blood pressure and heart rate. Atherosclerosis. 2010; 209(1): 255-60. https://dx.doi.org/10.1016/j.atherosclerosis.2009.08.047.

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