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Epidemiology and outcomes
Original research
Serum uric acid is associated with damage in patients with systemic lupus erythematosus
  1. Claudia Elera-Fitzcarrald1,2,
  2. Cristina Reátegui-Sokolova2,3,
  3. Rocio Violeta Gamboa-Cardenas2,
  4. Mariela Medina2,
  5. Francisco Zevallos2,
  6. Victor Román Pimentel-Quiroz2,
  7. Jorge Mariano Cucho-Venegas2,
  8. José Alfaro-Lozano2,
  9. Zoila Rodriguez-Bellido2,4,
  10. Cesar Augusto Pastor-Asurza2,4,
  11. Risto Alfredo Perich-Campos2,4,
  12. Graciela S Alarcón5,6 and
  13. Manuel Francisco Ugarte-Gil1,2
  1. 1School of Medicine, Universidad Científica del Sur, Lima, Peru
  2. 2Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
  3. 3Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignancio de Loyola, Lima, Peru
  4. 4Universidad Nacional Mayor de San Marcos, Lima, Peru
  5. 5Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama, Birmingham, Alabama, USA
  6. 6Department of Medicine, Universidad Peruana Cayetana Heredia, Lima, Peru
  1. Correspondence to Dr Claudia Elera-Fitzcarrald; claudiaelerafitz{at}gmail.com

Abstract

Introduction Serum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.

Objective To determine whether serum uric acid levels are associated with new damage in patients with SLE.

Methods This is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.

Results We evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).

Conclusion Higher serum uric acid levels are associated with global damage in patients with SLE.

  • systemic lupus erythematosus
  • autoimmune diseases
  • autoimmunity
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/lupus-2019-000366

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    Footnotes

    • Twitter @VictorioPQ, @mugartegil

    • Presented at The manuscript is based on a work previously presented at a conference and published as a conference abstract in 2018 (SAT0426 Serum uric acid levels predict damage accrual in systemic lupus erythematosus patients, Annals of the Rheumatic Diseases 2018; doi: 10.1136/annrheumdis-2018-eular.6128).

    • Contributors All authors were involved in drafting or revising this article critically for important intellectual content, and all approved the final version to be published. CE-F has full access to all of the data from the study and takes responsibility for their integrity and the accuracy of the analyses performed.

    • Funding This work was partially supported by an institutional grant from EsSalud (1483-GCGP-ESSALUD-2013, 1733-GCGP-ESSALUD-2014 and 04-IETSI-ESALUD-2016 2015, Kaelin Prize) and one from the Panamerican League of Associations for Rheumatology (PANLAR) (2015 PANLAR Prize).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study had been approved by the Institutional Review Board of Hospital Nacional Guillermo Almenara Irigoyen, EsSalud (3474-OCID-G-RAA-ESSALUD-11, 271-CEI-CID-G-RAA-ESSALUD-13, 302-CEI-ICD-G-RAA-14, 3027-OCID-G-RAA-ESSALUD-15). Patients who signed the informed consent were recruited into the cohort.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. If more information is needed, please contact MFU-G.