Suchanda Sahu, Debapriya Bandyopadhyay, Sanjukta Naik, Sujit Tripathy
Background: Osteoarthritis (OA), characterized pain and stiffness of joints has many risk factors. Of the many triggers, uric acid has been reported to initiate inflammation and drive the disease to severe forms. However, due to controversial reports, our study was designed to investigate the association of serum uric acid (sUA) levels in the different grades of Knee OA. Methods: This cross-sectional study included 80 patients of knee OA, > 40 years of age, of both sexes who had not received any treatment other than analgesics. Subjects were stratified into 4 grades based on Kellgren and Lawrence radiological grading system. A detailed history of signs and symptoms, comorbidities, dietary and drug intake history were taken. The laboratory tests done were erythrocyte sedimentation rate (ESR), Creactive protein (CRP) and sUA. Further reclassification of study population was done as early stage (grades 1& 2) and advanced stage (grades 3 & 4). Results: There was no difference in age, ESR and CRP levels in the four grades of OA. However, the sUA was statistically different (p = 0.012) in the groups and there was a progressive decrease in the range of movement (ROM) with the disease severity (p = 0.001). The uric acid levels in males (p= 0.044), the ROM (p= 0.00038), and the VAS (p= <0.001) were significantly different in the early and advanced stages, but not in females. Uric acid was observed to be negatively correlated (r = -0.235, n = 80, p = 0.036) with disease severity. Conclusions: There is an inverse relationship of serum uric acid with knee OA, which may be joint specific. Due to the excess consumption of uric acid in its role as an antioxidant, supplements of antioxidants are suggested. We propose the consideration of subpopulations among knee OA patients whose management should be with the objective of alleviating their discomfort and arresting the disease progression.
