Hyperuricemia in psoriatic arthritis: clinical correlations and implications

Abstract

BACKGROUND: Psoriatic arthritis (PsA) patients may have elevated serum uric acid levels, and hyperuricemia may impact the degree of inflammation and clinical disease severity. OBJECTIVES: comparison between PsA patients with and without hyperuricemia and assessment of the effect of hyperuricemia on clinical presentation, disease activity, disease severity, and associated comorbidities in PsA patients. METHODS: 76 PsA patients with hyperuricemia and 74 PsA patients with normal uric acid as control were included. Demographic, clinical, comorbidities, and laboratory data were collected. Hyperuricemia threshold ≥ 60 mg/L. RESULTS: There were no significant differences between patients with and without hyperuricemia regarding gender, PsA articular subtype, PASI score, and treatment received, while patients with hyperuricemia were older (40.47 ± 8.53 vs 34.59 ± 7.29, p = 0.0001), had more comorbidity, higher body mass index (BMI) (28.49 ± 2.07 vs 26.91 ± 1.63kg/m2, p = 0.0001), DAPSA score (16.75 ± 7.04 vs 9.32 ± 6.35, p = 0.0001), ESR (34.78 ± 7.12 vs 28.55 ± 8.97, p = 0.0001), CRP (11.42 ± 3.23 vs 8.68 ± 4.04, p = 0.0001), serum cholesterol (220.42 ± 46.83 vs 169.82 ± 37.82, p = 0.0001), and triglycerides (136.47 ± 36.4 vs 104.89 ± 22.15, p = 0.0001), and longer duration of Psoriasis and PsA. The serum uric acid levels were significantly positively correlated with age, duration of Psoriasis, duration of PsA, BMI, CRP, ESR, DAPSA, and PASI score. Multivariate analysis showed that male sex, BMI, and increased disease activity were independent predictors of hyperuricemia in PsA patients. CONCLUSION: Psoriatic arthritis patients with hyperuricemia have higher age, BMI, disease activity, and more associated comorbidities. In PsA patients, hyperuricemia was associated with male sex, BMI, and increased disease activity, but not associated with PASI score. Key Points • Psoriasis, PsA, and hyperurice s is a bi-centric case-control retrospective of cardiovascular disease. • Male gender, BMI, and increased disease activity were independent predictors of hyperuricemia in PsA patients. • Psoriatic arthritis patients with hyperuricemia have been more associated with comorbidities.