Association of neutrophil-to-lymphocyte ratio with renal impairment among patients with acute gouty arthritis.

OBJECTIVE: Gouty arthritis (GA) is an inflammatory disease, and renal impairment may occur to varying degrees with the progress of disease. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker. In this study, we aimed to explore the association between NLR and renal impairment in GA. MATERIALS AND METHODS: The subjects comprised 499 patients with gouty arthritis (GA) (473 men, 26 women; age range, 39-61 years old) from our hospital. They were divided into a chronic kidney disease (CKD) group (n = 206) and non-CKD group (n = 293) according to the glomerular filtration rate. Blood samples were collected during the gout flares. The differences in NLR, general data, and laboratory indexes of patients with GA between the two groups were compared, such as serum uric acid (SUA), serum creatinine (SCREA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). RESULTS: NLR (3.38 vs. 2.38 (p < 0.001)) was higher in the CKD group, compared to the non-CKD group. Similarly, both SUA (527 vs. 507 (p < 0.05)) and SCREA (122 vs. 87 (p < 0.001)) were higher in the CKD group than in the non-CKD group. Multivariate logistic regression analysis showed that NLR (OR = 1.122, p < 0.05), age, hypertension, and SUA were risk factors for CKD in patients with GA, although HDL and HGB were protective factors. The receiver operating characteristic (ROC) curve analysis indicated that the area under the curve of NLR for predicting CKD in patients with GA was 0.646 (95% CI 0.597-0.694). CONCLUSION: Our data showed that NLR might be an important potential factor for evaluating renal impairment in GA during flares.

Serum Uric Acid Shows Inverted "U" Type Correlation with Osteoporosis in Chinese Ankylosing Spondylitis Patients: A Retrospective Study.

BACKGROUND This study was to investigate the correlation between osteoporosis and serum uric acid in ankylosing spondylitis (AS) patients, and to further identify potential factors that might be associated with osteoporosis in AS patients. MATERIAL AND METHODS We included 182 AS patients, consisted of 143 male patients and 39 female patients, who visited our hospital from January 1, 2014 to December 31, 2018. We used dual-energy x-ray absorptiometry to measure bone mineral density (BMD) of orthotopic lumbar vertebrae in patients with AS. The gender, age, disease duration, BMD, T-score, Z-score, uric acid, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), blood platelet (PLT), and status of treatment with biologics of the patients were collected. Then, the Spearman correlation coefficient and multivariate liner regression analysis were applied to identify the relationship between the factors and BMD, T-score, and Z-score in AS patients. RESULTS Male AS patients between the ages of 16 and 30 years old had a higher risk of osteoporosis (P<0.05). AS patients with uric acid value between 300-360 µmol/L had the highest BMD, T-score, and Z-score. The BMD had a positive correlation with age and disease duration (P<0.01) while had a negative correlation with PLT (P<0.05). BMD in AS patients with elevated ESR was significantly (P<0.05) lower than in AS patients with normal ESR. There were no significant differences in BMD between AS patients with elevated CRP and the patients with normal CRP and PLT. Treatment with TNFi (tumor necrosis factor alpha inhibitor) did not improve BMD in AS patients. CONCLUSIONS The relationship between uric acid and BMD in AS patients was observed as inverted "U"-type. Keeping uric acid within 300-360 µmol/L might be helpful in preventing AS patients from developing osteoporosis.

Plasma D-dimer is a Promising Indicator for the Treatment of Acute Gouty Attack.

BACKGROUND AND AIM: Gout is an inflammatory disease affecting multiple joints. Abnormal coagulation can elevate the levels of plasma D-dimer (DD) and is associated with inflammation and joint-related disease activity. Patients with gout usually develop acute gouty attack. However, there is no information on whether abnormal levels of plasma DD are associated with a gout flare. This study examined the levels of blood C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum uric acid (UA) and plasma DD in patients with gout flare and those with gout in remission phase and evaluated their value in predicting a gout flare as well as in the treatment of gout flare. METHODS: The levels of serum UA, plasma DD and blood CRP as well as blood ESR in 50 patients with gout flare and 27 patients with gout in remission phase were determined. The data were stratified and their potential values in predicting the onset of gout flare were analyzed by receiver-operating characteristic (ROC) analysis. RESULTS: The levels of DD, CRP and ESR in patients with gout flare were significantly higher than that in patients with gout in remission. The ROC analysis indicated that the area under curve (AUC) of DD, ESR as well as CRP were 0.914 (95% CI: 0.909~1.001, p<0.05), 0.956 (95%CI: 0.917~0.994, p<0.05), and 0.942 (95%CI: 0.894~0.989, p<0.05), respectively. The current study revealed that sensitivity of plasma DD concentration in predicting gout attack was significantly higher than that of blood ESR (p<0.05). CONCLUSION: Plasma DD may be a sensitive biomarker in predicting the onset of gout flare, but more importantly, it might serve as an indicator of treatment for the dysfunction of blood coagulation in gout patients.