Hu Qiongwen, Cheng Xiaocheng, Lan Ying, Lei Huxin, Niu Changchun, Luo Yang
Chongqing Medical University, Chongqing, China.
Department of Clinical Laboratory, Chongqing General Hospital, Chongqing University, Chongqing, China.
Front Med (Lausanne). 2025 Aug 5;12:1623557. doi: 10.3389/fmed.2025.1623557. eCollection 2025.
It is critical to identify novel biomarkers for the prediction and prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).
The objective of the study was to investigate the predictive and prognostic significance of serum uric acid (UA) in RA-ILD.
In this multicenter retrospective cohort study, demographic data, medical history, and laboratory results of 829 RA patients were extracted from electronic medical records between December 2018 and January 2024. The cohort was divided into an RA-ILD group ( = 351) and an RA-no-ILD group ( = 478).
The primary endpoint was the predictive capacity of baseline UA levels for the occurrence of ILD in RA patients. The secondary endpoints were all-cause mortality and the rehospitalization rate in RA-ILD patients.
The univariate analysis identified elevated levels of UA as a significant risk factor for the development of ILD in RA patients (OR [95% CI]: 1.68 [1.23-2.28], = 0.001). The multivariate analysis confirmed that elevated levels of UA remained an independent risk factor. The subgroup analysis demonstrated a stronger predictive utility of elevated UA levels in younger RA patients (age < 65), particularly those with shorter disease duration and no comorbidities (OR [95% CI]: 3.66 [1.66-8.05], = 0.001; AUC = 0.718). During follow-up, RA-ILD patients with elevated UA levels exhibited significantly higher all-cause mortality (22.1% vs. 13.1%; HR [95% CI]: 1.80 [1.03-3.17], = 0.040) and rehospitalization rates (51.9% vs. 44.4%; HR [95% CI]: 1.41 [1.00-1.98], = 0.047) compared to those with lower UA levels.
Elevated levels of serum UA may serve as a predictive marker for ILD development in RA patients, particularly in younger individuals without comorbidities, and a prognostic indicator for increased mortality and rehospitalization rates in RA-ILD patients.
ClinicalTrials.gov, identifier NCT06036537.
识别类风湿关节炎相关间质性肺病（RA-ILD）预测和预后的新型生物标志物至关重要。
本研究旨在探讨血清尿酸（UA）在RA-ILD中的预测和预后意义。
设计、地点和参与者：在这项多中心回顾性队列研究中，从2018年12月至2024年1月的电子病历中提取了829例RA患者的人口统计学数据、病史和实验室结果。该队列分为RA-ILD组（n = 351）和RA无ILD组（n = 478）。
主要终点是基线UA水平对RA患者ILD发生的预测能力。次要终点是RA-ILD患者的全因死亡率和再住院率。
单因素分析确定UA水平升高是RA患者发生ILD的显著危险因素（OR[95%CI]：1.68[1.23 - 2.28]，P = 0.001）。多因素分析证实UA水平升高仍然是一个独立危险因素。亚组分析表明，UA水平升高在年轻RA患者（年龄<65岁）中具有更强的预测效用，尤其是那些病程较短且无合并症的患者（OR[95%CI]：3.66[1.66 - 8.05]，P = 0.001；AUC = 0.718）。在随访期间，UA水平升高的RA-ILD患者全因死亡率（22.1%对13.1%；HR[95%CI]：1.80[1.03 - 3.17]，P = 0.040）和再住院率（51.9%对44.4%；HR[95%CI]：1.41[1.00 - 1.98]，P = 0.047）显著高于UA水平较低的患者。
血清UA水平升高可能作为RA患者ILD发生的预测标志物，特别是在无合并症的年轻个体中，也是RA-ILD患者死亡率和再住院率增加的预后指标。
ClinicalTrials.gov，标识符NCT06036537。
