Rheumatology Advance Access originally published online on July 21, 2007
Rheumatology 2007 46(9):1466-1470; doi:10.1093/rheumatology/kem159
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Association of serum uric acid with cardiovascular disease in rheumatoid arthritis
1Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, West Midlands, UK, 2Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece and 3Wolfson Computer Laboratory, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
*Correspondence to: Professor George D. Kitas, MD, PhD, FRCP, Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands, DY1 2HQ, UK. E-mail: gd.kitas{at}dgoh.nhs.uk; g.d.kitas{at}bham.ac.uk
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Abstract |
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Objectives. Elevated serum uric acid (SUA) levels have been associated with cardiovascular disease (CVD) in the general population. Rheumatoid arthritis (RA) is not thought to associate with high SUA but is characterized by increased CVD morbidity and mortality. We aimed to explore a potential association of SUA with CVD in RA patients and to evaluate whether such an association is present when the traditional CVD risk factors are taken into account.
Methods. 400 consecutive RA patients were recruited in this cross-sectional study and had all traditional CVD risk factors and SUA assessed. The association of SUA levels with other variables was assessed using bivariate correlations. Subsequent binary logistic models with appropriate adjustments were used to test the independence of the association between SUA and CVD.
Results. SUA levels were significantly higher in RA patients with CVD (RA + CVD) compared with RA patients without CVD (RA – CVD) (5.68 ± 1.81 mg dl–1 vs 5.06 ± 1.41 mg dl–1, P = 0.001). After adjusting for CVD risk factors, physical function (health assessment questionnaire, HAQ) and use of diuretics and/or statins the association between SUA and CVD in RA patients remained significant [Odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.04–1.79, P = 0.025]. Compared with subjects with SUA levels in the lowest quintile (<3.86 mg dl–1), those within the highest quintile (
6.38 mg dl–1) had a 6-fold increase in the odds of having CVD (adjusted OR 6.46, 95% CI 1.66–25.05, P = 0.007).
Conclusions. This cross-sectional study suggests that SUA may be independently associated with CVD in RA patients. This needs to be confirmed in prospective studies.
KEY WORDS: Rheumatoid arthritis, Uric acid, Cardiovascular disease, Association
Submitted 2 March 2007;
revised version accepted 18 May 2007.
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