Go Dong Jin, Kim Dong Hyun, Kim Jie Young, Guermazi Ali, Crema Michel Daoud, Hunter David J, Kim Hyun Ah
Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine.
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul.
Rheumatology (Oxford). 2021 Oct 2;60(10):4581-4590. doi: 10.1093/rheumatology/keab048.
Emerging evidence suggests a potential link between OA and gout; however, the association between serum uric acid (UA) itself and knee OA remains uncertain due to a lack of longitudinal studies. Here, we investigated the association between serum UA and knee OA according to cartilage status in elderly community residents without gout.
In this longitudinal study, participants without a history of gout were recruited from among the Korean cohort of the Hallym Aging Study (n = 296 for radiography study and n = 223 for MRI study). Weight-bearing knee radiographs and 1.5-T MRI scans, along with blood collection for analysis of serum UA, were performed at baseline and after 3 years. The severity and structural progression of knee OA were evaluated using the Kellgren-Lawrence grading system and the Whole-Organ MRI Score (WORMS) cartilage scoring method. Multivariable logistic regression analysis was conducted using generalized estimating equation (GEE) models.
Serum UA levels were not associated with radiographic progression after adjusting for age, sex and BMI. There was no significant association between serum UA and tibiofemoral cartilage loss on MRI. However, baseline serum UA levels were negatively associated with patellofemoral cartilage loss over 3 years (adjusted odd ratio 0.70 per 1 mg/dl increase, 95% CI: 0.49, 0.98).
In this population-based cohort, serum UA was not a risk factor for knee OA progression. Further large-scale longitudinal studies in other populations are needed to validate the effects of UA on cartilage damage.
新出现的证据表明骨关节炎（OA）与痛风之间可能存在联系；然而，由于缺乏纵向研究，血清尿酸（UA）本身与膝关节OA之间的关联仍不确定。在此，我们根据软骨状态调查了无痛风的老年社区居民血清UA与膝关节OA之间的关联。
在这项纵向研究中，从韩瑞尔老龄研究的韩国队列中招募无痛风病史的参与者（X线摄影研究n = 296，MRI研究n = 223）。在基线和3年后进行负重膝关节X线摄影和1.5-T MRI扫描，并采集血液分析血清UA。使用Kellgren-Lawrence分级系统和全器官MRI评分（WORMS）软骨评分方法评估膝关节OA的严重程度和结构进展。使用广义估计方程（GEE）模型进行多变量逻辑回归分析。
在调整年龄、性别和体重指数后，血清UA水平与X线进展无关。血清UA与MRI上胫股软骨损伤之间无显著关联。然而，基线血清UA水平与3年内髌股软骨损伤呈负相关（每增加1mg/dl，调整后的比值比为0.70，95%CI：0.49，0.98）。
在这个基于人群的队列中，血清UA不是膝关节OA进展的危险因素。需要在其他人群中进行进一步的大规模纵向研究，以验证UA对软骨损伤的影响。
