Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
Do Metabolic Syndrome Components and Psoriatic Arthritis Affect the Uric Acid Level?
Metabolik Sendrom Komponentleri ve Psoriatik Artrit Ürik Asit Seviyelerini Etkiler mi?
Nurhan SAYACAa, Refik DERMİRTUNÇb, Yasemin ÖZGÜRc, Seval PEHLEVANd, Çetin SAYACAe
aDepartment of Allergy-Immunology, Manisa Celal Bayar University Faculty of Medicine, Manisa, TURKEY
bClinic of Internal Medicine, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, İstanbul, TURKEY
cClinic of Internal Medicine, Ministry of Health Istanbul Provincial Health Directorate İstanbul Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, TURKEY
dClinic of Rheumatology, Medicana Kadıköy Hospital, Fenerbahce University, İstanbul, TURKEY
eDepartment of Physical Therapy and Rehabilitation, Uludağ University Faculty of Health Sciences, Bursa, TURKEY
Turkiye Klinikleri J Intern Med. 2021;6(2):49-55
doi: 10.5336/intermed.2020-80333
Article Language: EN
Full Text
ABSTRACT
 Objective: Hyperuricemia is common in psoriatic arthritis (PsA). The aim of this study is to investigate the effect of PsA and metabolic syndrome (MS) components on serum uric acid (SUA). Material and Methods: A total of 102 adult individuals (53 females and 49 males) participated in this study. Fifty-one consecutive PsA patients followed and treated in the outpatient clinic between April 2011 and 2012 were enrolled in this study retrospectively. The control group consisted of 51 patients who have arthralgia but not arthritis. Insulin resistance was calculated according to the homeostasis model of assessment insulin resistance (HOMA-IR) formula. Patients were classified as having MS according to the National Cholesterol Education Program/Adult Treatment Panel definition. Results: SUA levels were higher in MS (p=0.016), but when adjusted for age, this difference was not found to be statistically significant. It was found that hypertension (HT), triglyceride (TG) and HOMA-IR which are important components of MS had an effect on SUA level but the effect of PsA on SUA was not found. SUA level was higher in patients with HT, TG and HOMA-IR elevation than those without (respectively, p=0.009, p=0.005, p=0.001). It was observed that PsA had no effect on SUA, but when adjusted for age, the UA level in PsA was found to be significantly higher (p=0.027). Conclusion: MS, which is a major risk factor for atherosclerosis, is increased in PsA. However, this increase may also be associated with higher age in PsA patients. It is known that there is a relationship between cardiovascular events and high SUA levels. SUA is known to play a potential role as a risk factor for atherosclerosis and related diseases. More studies are needed to investigate the effects of PsA and MS components on SUA levels.

Keywords: Metabolic syndrome; psoriatic arthritis; uric acid; insulin resistance
ÖZET
 Amaç: Hiperürisemi, psöriyatik artritte (PsA) yaygın görülmektedir. Bu çalışmanın amacı, PsA ve metabolik sendrom (MS) bileşenlerinin, serum ürik asit (SUA) üzerindeki etkisini incelemektir. Gereç ve Yöntemler: Bu çalışmaya, toplam 102 (53 kadın ve 49 erkek) erişkin birey katıldı. Çalışmaya, Nisan 2011-2012 tarihleri arasında poliklinikte takip ve tedavi edilen 51 ardışık PsA hastası retrospektif olarak alındı. Kontrol grubu, artraljisi olan ancak artriti olmayan 51 hastadan oluşuyordu. İnsülin direnci, insülin direncini değerlendirme (HOMA-IR) formülünün homeostaz modeline göre hesaplandı. Ulusal Kolesterol Eğitim Programı/Yetişkin Tedavi Paneli tanımına göre hastalar MS'li olarak sınıflandırıldı. Bulgular: SUA seviyeleri MS'de daha yüksekti (p=0,016), fakat yaşa göre düzeltme yapıldığında bu farkın, istatistiksel olarak anlamlı olmadığı tespit edildi. MS'nin önemli bileşenleri olan hipertansiyon (HT), trigliserid (TG) ve HOMA-IR'nin SUA düzeyi üzerine etkisi olduğu, ancak PsA'nın SUA üzerine etkisinin olmadığı bulundu. SUA düzeyi HT, TG ve HOMA-IR yüksekliği olan hastalarda, olmayanlara göre daha yüksekti (sırasıyla; p=0,009, p=0,005, p=0,001). PsA'nın SUA üzerine etkisinin olmadığı, ancak yaşa göre düzeltme yapıldığında PsA'da, SUA düzeyinin anlamlı şekilde yüksek saptandığı görüldü (p=0,027). Sonuç: Ateroskleroz için önemli bir risk faktörü olan MS, PsA'da artmıştır. Fakat bu artış, PsA hastalarındaki yüksek yaşla da ilişkili olabilir. Kardiyovasküler olaylar ile yüksek SUA seviyeleri arasında ilişki olduğu bilinmektedir. SUA'nın, ateroskleroz ve ilgili hastalıklar için bir risk faktörü olarak potansiyel bir rol oynadığı bilinmektedir. PsA ve MS bileşenlerinin, SUA seviyeleri üzerindeki etkilerini araştırmak için daha fazla sayıda çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Metabolik sendrom; psöriyatik artrit; ürik asit; insülin direnci
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