Serum uric acid and self-reported rheumatoid arthritis in a multiethnic adult female population

Abstract

Objective:

Studies suggest that serum uric acid (SUA) is significantly associated with cardiovascular disease (CVD) mortality among women and blacks. CVD rates are higher among patients with rheumatoid arthritis (RA) than the normal population. The objective of this study was to determine if there was an association between SUA levels and self-reported RA in a multiethnic female population in the United States.

Methods:

This cross-sectional study was conducted using data for 7374 women above 20 years of age in the Third National Health and Nutrition Examination Survey. Multiple and logistic regression methods were used to determine an association between SUA levels and self-reported RA.

Results:

Women self-reporting RA had significantly higher SUA levels (p < 0.0001) compared to women not self-reporting RA, also when adjusted for age and race (p < 0.0001). In a regression analysis, significant predictors of SUA levels were: self-reporting RA, race/ethnicity, being married, smoking, use of alcohol, high body mass index, high C-Reactive protein, elevated diastolic or systolic blood pressure, and increased glomerular filtration rate. Education and age were removed from the model. The model explained 24.0% of the variability seen in SUA levels (F = 208.62, p < 0.0001) in this multiethnic female population. When the analyses were repeated stratified by race, self-reporting RA was retained in the model as associated with SUA in white and Mexican American, but not in black women.

Conclusion:

Despite the limitations imposed by self-reporting of RA on self-administered questionnaires and in-person interviews, practitioners should be aware that women self-reporting RA are at risk of having high SUA levels as well as more traditional CVD risk factors. These women should be offered appropriate preventive interventions related to their increased risk for CVD events.

Key words::

• Cardiovascular disease
• C-reactive protein
• Glomerular filtration rate
• Rheumatoid arthritis
• Uric acid

Transparency

Declaration of funding

Mittie K. Doyle was supported by a Building Interdisciplinary Research Careers in Women's Health Scholarship (K12-HD43451) co-funded by the Office of Research on Women's Health and the Office of Dietary Supplements of the National Institutes of Health (Bethesda, MD).

Declaration of financial/other relationships

At the time of the study all authors were employed by Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. M.K.D. has declared that she is currently an employee of Centocor Research & Development, Inc., Malvern, PA and University of Pennsylvania School of Medicine, Rheumatology, Philadelphia, PA. Peer reviewers may receive honoraria from CMRO for their review work. Peer Reviewer 1 has disclosed that he/she is a consultant to, and a shareholder in Labopharm Inc. Peer Reviewer 2 has disclosed no relevant financial relationships.