Association of serum uric acid with clinical and radiological severity of knee osteoarthritis in non-gouty patients

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.

The Association of Vitamin D, Growth/Differentiation Factor 5 (GDF-5) Gene Polymorphism, and Serum GDF-5 Protein in Obese Patients With Knee Osteoarthritis

“…Interestingly, this connection was not observed in male patients. These results highlight the importance of understanding the gender-specific nature of the relationship between uric acid and KOA severity [28].…”

“…This disparity emphasizes the potential role of uric acid in the development of KOA and provides valuable insights into its relevance for understanding the underlying mechanisms of the disease. A study by Bassiouni et al (2021) reported that there is a strong link between uric acid levels and the severity of KOA in female patients. Interestingly, this connection was not observed in male patients.…”

Association between hyperuricemia and the risk of mortality in patients with osteoarthritis: A study based on the National Health and Nutrition Examination Survey database

“…In a survey of 3099 individuals aged 65 and older, hyperuricemia was associated with hand OA in women, and hyperuricemia was significantly related to knee OA in men [ 21 ]. One study focused on the association of serum uric acid with the clinical and radiological severity of knee OA and found that the group with higher serum uric acid exhibited more severe changes, including a higher frequency of Kellgren-Lawrence (KL) grade 4, grade 4 osteophytes, and narrower joint space width (JSW) [ 14 ]. Our findings revealed that in patients with OA, hyperuricemia was associated with an increased risk of all-cause mortality and CVD mortality.…”

“…Hyperuricemia has also been found to be associated with a higher prevalence of hand OA [ 13 ]. In a study specifically examining knee OA, patients with higher serum uric acid levels displayed more severe symptoms and radiological signs of knee OA, including more severe pain, stiffness, and function scores [ 14 ]. However, there is a lack of research exploring the relationship between hyperuricemia and the overall mortality risk or the risk of CVD death in patients with OA from the literature search by the authors.…”