Uric Acid-Knee OA
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), C-reactive protein (CRP) and sUA. Further reclassification of study population was done as early stage (grades 1& 2) and advanced stage (grades 3 & 4).
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The cases were diagnosed with OA of knee based on the clinical signs and symptoms like pain, swelling, range of movement (ROM) and clinical history from the outpatient department of Orthopaedics. The Norkin and White (9) technique was used to measure the ROM of knees and the maximum was noted for each patient. A Visual Analogue Scale (VAS) was used to measure pain for our patients. It was a 11 point score starting from 0 which was no pain to a maximum of 10 which denoted severe pain which disabled the subject to perform his/her routine activities. Patients suffering from any kind of infectious disease, autoimmune, acute or chronic inflammatory condition, primary bone malignancy or metastasis were excluded from the study. Patients under treatment with any other drugs or steroids for any other indications or having any h/o alcohol intake or smoking were also excluded from the study. A detailed history of signs and symptoms, comorbidities, dietary and drug intake history were taken and recorded for each subject. The erythrocyte sedimentation rate (ESR) was measured in whole blood using a modified Westergren method by the automated analyzer Ves-matic Cube 30, Transasia, India. The normal reference ranges were 1–13 mm/hour for males and 1–20 mm/hour for females. Serum biochemistry included renal and liver function tests (RFT’s; LFT’s), uric acid by colorimetric kits and C-reactive protein (CRP) by immunoturbidimetric technique. They were measured using AU5800 Beckman Coulter auto-analyser (Beckman Coulter Inc., Brea, CA, USA), using commercially available reagents Statistical analysis was performed using SPSS 19.0. Data was presented as mean ± Standard deviation as appropriate. The radiological findings were considered as dichotomous data that is either absent/present and were compared using Fisher’s Exact test. The comparison between means of the 2 groups early an advanced was done using unpaired student T test. One-way analysis (ANOVA) was done to compare then levels within the 4 grades. Correlation between variables and disease severity were calculated using Pearson’s correlation and p <0.05 was considered to be significant.