İleri evre semptomatik diz osteoartritinde asemptomatik hiperürisemi sıklığı ve inflamatuar parametreler ile ilişkisi

Abstract

Amaç: Hiperüriseminin diz OA gelişmesinde ve ilerlemesinde risk faktörü olduğu düşünülmektedir. Çalışmamızda ileri evre diz OA hastalarında asemptomatik hiperürisemi sıklığı ve sistemik inflamasyonla ilişkili olup olmadığının araştırılması amaçlandı. Gereç ve yöntem: Semptomatik diz OA olan ve radyografik Kellgren-Lawrence (K-L) sistemine göre derece 3 veya 4 olarak sınıflandırılan hastaları dahil eden tek merkezli, retrospektif bir çalışmadır. Yaş, cinsiyet, komorbiditeler, kullanılan ilaçlar, serum ürik asit (ÜA), hemogram parametreleri, eritrosit sedimantasyon hızı (ESH), C-reaktif protein (CRP) ve vücut kitle indeksi (VKİ) kaydedildi. Nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (TLO) ve sistemik immün-inflamasyon indeksi (Sİİ)=[(nötrofil sayısı × trombosit sayısı)/lenfosit sayısı] hesaplandı. Hiperürisemisi olan ve olmayan hastalar sırasıyla Grup 1 ve Grup 2 olarak tanımlandı ve gruplar arasında demografik ve laboratuvar veriler karşılaştırıldı. Bulgular: 240 hastanın 51’ inde hiperürisemi mevcuttu (%21). Grup 1’de yaş ortalaması 70.54±7.02, BKİ 34 kg/m2 (27.7-41), grup 2’ de yaş ortalaması 68.63±6.29, BKİ 32 kg/m2 (25- 51.5), gruplar arasında anlamlı fark yoktu. Grup 1 ve Grup 2 arasında NLO, TLO, Sİİ arasında fark yoktu (p=0.404, p=0.604, p=0.537). Her iki grup arasında ESH değerlerinde fark yokken (p=0.051), CRP düzeyleri grup 1’de anlamlı yüksek saptandı (p=0.007). Grup 2’ de ÜA düzeyi ile CRP (rho=0.243**, p<0.001), Sİİ (rho=0.173*, p=0.017), NLO (rho=0.154*, p=0.035) ve PLO (rho=0.166*, p=0.023) pozitif ilişki tespit edildi. Ancak Grup 1’ de ÜA düzeyi ile ESH, CRP, Sİİ, NLO, PLO ve VKİ arasında ilişki yoktu. Sonuç: Çalışmamızda ileri evre diz OA hastalarının yaklaşık 5’de 1’inin asemptomatik hiperürisemisinin olduğu gözlendi. Asemptomatik HÜ, diz OA’ da inflamasyona neden olabilir, sonuç olarak bu hastalarda serum ÜA seviyesinin normale çekilmesi gerekebilir.

Keywords

• Asemptomatik hiperürisemi
• hiperürisemi
• diz osteoartriti
• sistemik inflamasyon

Frequency of asymptomatic hyperuricemia in advanced-stage symptomatic knee osteoarthritis and its relationship with inflammatory parameters

Abstract

Purpose: Hyperuricemia (HU) is thought to be a risk factor in the development and progression of knee osteoarthritis (OA). We sought the frequency of asymptomatic HU in advanced knee OA patients and whether it was related to systemic inflammation. Materials and methods: This is a single-center, retrospective study including patients with symptomatic stage 3/4 knee OA classified based on Kellgren-Lawrence (K-L) system. Demographic data and serum uric acid (UA), hemogram parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), body mass index (BMI) were recorded. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immune-inflammation index (SII)=[(neutrophil count × platelet count)/lymphocyte count] were calculated. Patients with/without hyperuricemia were defined as Group 1 and Group 2, respectively. Demographic and laboratory data were compared between the groups. Results: Hyperuricemia was present in 51 of 240 patients (21%). There was no significant difference between the groups based on age (Group1: 70.54±7.02, Group2: 68.63±6.29, p=0.07) and BMI (Group 1: 34 kg/m2 (27.7-41), Group2: 32 kg/m2 (25-51.5), p=0.107). NLR, PLR, and SII were similar between two groups (p=0.404, p=0.604, p=0.537). While there was no difference in ESR values between the two groups (p=0.051), CRP levels were found to be significantly higher in Group 1 (p=0.007). A positive correlation was detected between serum UA level and CRP (rho=0.243**, p<0.001), SII (rho=0.173*, p=0.017), NLR (rho=0.154*, p=0.035) and PLR (rho=0.166*, p=0.023) in Group 2. No correlation was detected between serum UA level and ESR, CRP, SII, NLR, PLR and BMI in Group 1. Conclusion: Asymptomatic HU was found 1 in 5 of advanced-stage knee OA patients and may contribute to inflammation in knee OA. Serum UA level may need to be reduced to normal level in these patients.

Keywords

• Asymptomatic hyperuricemia
• hyperuricemia
• knee osteoarthritis
• systemic inflammation

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