Department of Endocrinology and Metabology, The Affiliated Hospital of Qingdao University.
Department of Rheumatology & Clinical Immunology, the Affiliated Hospital of Qingdao University.
Rheumatology (Oxford). 2020 Oct 1;59(10):2872-2880. doi: 10.1093/rheumatology/keaa046.
Serum CA72-4 levels are elevated in some gout patients but this has not been comprehensively described. The present study profiled serum CA72-4 expression in gout patients and verified the hypothesis that CA72-4 is a predictor of future flares in a prospective gout cohort.
To profile CA72-4 expression, a cross-sectional study was conducted in subjects with gouty arthritis, asymptomatic hyperuricaemia, four major arthritis types (OA, RA, SpA, septic arthritis) and healthy controls. A prospective gout cohort study was initiated to test the value of CA72-4 for predicting gout flares. During a 6-month follow-up, gout flares, CA72-4 levels and other gout-related clinical variables were observed at 1, 3 and 6 months.
CA72-4 was highly expressed in patients with gouty arthritis [median (interquartile range) 4.55 (1.56, 32.64) U/ml] compared with hyperuricaemia patients [1.47 (0.87, 3.29) U/ml], healthy subjects [1.59 (0.99, 3.39) U/ml] and other arthritis patients [septic arthritis, 1.38 (0.99, 2.66) U/ml; RA, 1.58 (0.95, 3.37) U/ml; SpA, 1.56 (0.98, 2.85) U/ml; OA, 1.54 (0.94, 3.34) U/ml; P < 0.001, respectively]. Gout patients with frequent flares (twice or more in the last year) had higher CA72-4 levels than patients with fewer flares (fewer than twice in the last year). High CA72-4 level (>6.9 U/ml) was the strongest predictor of gout flares (hazard ratio = 3.889). Prophylactic colchicine was effective, especially for patients with high CA72-4 levels (P = 0.014).
CA72-4 levels were upregulated in gout patients who experienced frequent flares and CA72-4 was a useful biomarker to predict future flares.
一些痛风患者的血清 CA72-4 水平升高，但这尚未得到全面描述。本研究对痛风患者的血清 CA72-4 表达进行了分析，并验证了 CA72-4 是前瞻性痛风队列中未来发作的预测因子的假设。
为了分析 CA72-4 的表达，我们进行了一项横断面研究，纳入了痛风性关节炎、无症状高尿酸血症、四种主要关节炎类型（OA、RA、SpA、化脓性关节炎）和健康对照组的受试者。启动了一项前瞻性痛风队列研究，以检验 CA72-4 预测痛风发作的价值。在 6 个月的随访期间，在 1、3 和 6 个月时观察痛风发作、CA72-4 水平和其他痛风相关的临床变量。
与高尿酸血症患者[1.47（0.87，3.29）U/ml]、健康受试者[1.59（0.99，3.39）U/ml]和其他关节炎患者[化脓性关节炎，1.38（0.99，2.66）U/ml；RA，1.58（0.95，3.37）U/ml；SpA，1.56（0.98，2.85）U/ml；OA，1.54（0.94，3.34）U/ml]相比，痛风性关节炎患者的 CA72-4 水平显著升高[中位数（四分位数间距）4.55（1.56，32.64）U/ml；P<0.001]。在过去一年中频繁发作（两次或以上）的痛风患者的 CA72-4 水平高于发作次数较少的患者（过去一年少于两次）。高 CA72-4 水平（>6.9 U/ml）是痛风发作的最强预测因子（风险比=3.889）。预防性秋水仙碱治疗有效，尤其是对于 CA72-4 水平较高的患者（P=0.014）。
频繁发作的痛风患者的 CA72-4 水平升高，CA72-4 是预测未来发作的有用生物标志物。
