Features of the course of osteoarthritis in patients with asymptomatic hyperuricemia


DOI: https://dx.doi.org/10.18565/therapy.2025.1.16-28

Bashkinov R.A., Mazurov V.I., Gaydukova I.Z., Inamova O.V., Petrova M.S.

1) I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 2) V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg
Abstract. Due to the high prevalence of osteoarthritis (OA) and hyperuricemia and their shared risk factors, the combination of these pathological conditions represents a serious problem in real-life clinical practice.
The aim: to determine the features of the course of OA in patients with asymptomatic hyperuricemia (AHU).
Material and methods. The follow-up included 1038 patients with OA who met the inclusion criteria, divided into two groups: 538 patients with AHU and 500 patients with normal serum uric acid (UA) levels.
Results. Elevated serum UA levels in patients with OA were associated with a higher prevalence of lesions of the interphalangeal joints of the hands (9.1 vs 5.6%; p = 0.031), osteonecrosis of various localizations (5.2 vs 2.2%; p = 0.011) and a history of joint replacement (2.6 vs 1.0%; p = 0.044). Bone erosions (14.0 vs 2.3%; p = 0.047), as well as the total number of ultrasound signs of deposits of monosodium urate crystals (24.0 vs 2.3%; p = 0.002), were significantly more frequently reported among patients suffering from AHU. In patients with OA with AHU, the average levels of high-sensitivity C-reactive protein (4.9 [4.0;7.9] vs 2.9 [1.2;6.3] mg/l; p = 0.007) were significantly higher, while serum levels of interleukin (IL)-6 and IL-8 they did not differ significantly. Prevalence of hypertension (80.5 vs 55.5%; p <0.001), heart failure (17.5 vs 6.6%; p <0.001), atrial fibrillation and atrial flutter (5.4 vs 1.8%; p = 0.002), hypercholesterolemia (68.8 vs 62.9%; p = 0.047), chronic kidney disease (54.1 vs 28.1%; p <0.001), type 2 diabetes mellitus (29.2 vs 13.4%; p <0.001) and obesity (49.6 vs 16.4%; p <0.001) were significantly higher in patients with OA with AHU.
Conclusion. Analysis of the data from the study allows us to classify AHU as modifiable risk factors for more severe joint damage and multimorbidity in patients with OA. It can be assumed that non-medicinal and medicinal methods of treating AHU in OA can be useful not only to achieve the target serum UA levels and improve the course of OA, but also to increase the effectiveness of complex therapy for a wide range of comorbid diseases.
Keywords: asymptomatic hyperuricemia, comorbidity, osteoarthritis, uric acid, hyperuricemia
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About the Autors

Roman A. Bashkinov, MD, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at V.A. Nasonova Clinical Rheumatology Hospital No. 25. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: bashkinov-roman@mail.ru
ORCID: https://orcid.org/0000-0001-9344-1304. Scopus Author ID: 57221994610. eLibrary SPIN: 5169-5066
Vadim I. Mazurov, MD, Dr. Sci. (Medicine), professor, academician of RAS, vice president of RSMSIM, principal scientific advisor and director of the Research Institute of Rheumatology, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, head of Autoimmune center of V.A. Nasonova Clinical Rheumatology Hospital No. 25, chief freelance specialist – rheumatologist of the Healthcare Committee of the Government of Saint Petersburg, Honored Worker of Science of the Russian Federation. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: maz.nwgmu@yandex.ru
ORCID: https://orcid.org/0000-0002-0797-2051. Scopus Author ID: 16936315400. eLibrary SPIN: 6823-5482
Inna Z. Gaydukova, MD, Dr. Sci. (Medicine), deputy director of the Research Institute of Rheumatology, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at V.A. Nasonova Clinical Rheumatology Hospital No. 25. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: ubp1976@list.ru
ORCID: https://orcid.org/0000-0003-3500-7256. Scopus Author ID: 55237525900. eLibrary SPIN: 3083-7996
Oksana V. Inamova, MD, PhD (Medicine), deputy director of the Research Institute of Rheumatology, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, chief physician of V.A. Nasonova Clinical Rheumatology Hospital No. 25. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: ovig74@mail.ru
ORCID: https://orcid.org/0000-0001-9126-3639. eLibrary SPIN: 8841-5496
Marianna S. Petrova, MD, PhD (Medicine), associate professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, deputy chief physician of V.A. Nasonova Clinical Rheumatology Hospital No. 25. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: podagra@bk.ru
ORCID: https://orcid.org/0000-0001-5261-6614


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