Karthiga Murugan1, Velmurugan Anbu Ananthan2, Ananthan Veeranan3
BACKGROUND
Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disorder. Uric
acid is a by-product of purine metabolism, associated with diseases such as gouty
arthritis, hypertension and cardiovascular disease (CVD). The association between
serum uric acid concentrations and inflammation in patients with RA has been
controversial. Some case reports suggest coexistence of gout and RA. Uric acid
crystals can induce robust inflammation causing joint destruction and fibrosis. The
purpose of this study was to estimate the serum uric acid levels in subjects with
recently diagnosed rheumatoid arthritis and to correlate with disease activity.
METHODS
This cross-sectional study was done on 55 recently diagnosed RA subjects
[American college of Rheumatology (ACR) criteria 2010] attending the
rheumatology out-patient department (OPD) of a tertiary care institute in Chennai,
Tamil Nadu. After clinical examination, evaluation of disease activity score (DAS),
serum uric acid and rheumatoid factor (RF) were done. Data was analysed using
Statistical Package for Social Sciences (SPSS trial version 28). Descriptive and
inferential analysis was done. Correlation between serum uric acid levels and DAS
was the main outcome.
RESULTS
The mean age was 41.51 ± 11.7 years. 87.3 % were females. Majority (58.2 %)
were aged between 31 to 50 years. The mean duration of symptoms was 4.78
months. The mean serum uric acid level was 4.99 ± 1.2 mg/dl with 95 % C.I. of
4.66 to 5.31. The mean DAS was 5.34 ± 0.96. 56 % had high disease activity
while only 44 % had moderate disease activity. 44 % were RF positive. There was
no significant difference in serum uric acid levels across groups based on RF
positivity and DAS severity respectively. There was no statistically significant
correlation serum uric acid levels and DAS (-0.024, P value = 0.861).
CONCLUSIONS
Mean serum uric acid levels were elevated in recently diagnosed rheumatoid
arthritis. Serum uric acid levels have no association with DAS and RF positivity in
rheumatoid arthritis. Further studies are needed to investigate the role of specific
treatment of elevated uric acid levels in rheumatoid arthritis independent of
rheumatoid arthritis treatment.
