Association between serum uric acid and inflammation markers in ankylosing spondylitis patients treated with tumor necrosis factor-α or nonsteroidal anti-inflammatory drugs
Methods: A total of 132 ankylosing spondylitis patients fulfilling the 1984 Modified New York Criteria who had serum uric acid, erythrocyte sedimentation rate and C-reactive protein levels in medical records were included in this retrospective cross-sectional study. Patients were divided in two groups (anti-TNF-α and NSAIDs). Their files were examined in detail. Later demographic and laboratory features were recorded to the research form.
Results: Serum uric acid levels were significantly lower in the anti-TNF-α group (mean: 4.9 mg/dL, range: 4.10-5.45 mg/dL) than in the NSAIDs group (mean: 5.20 mg/dL, range 4.70-5.90 mg/dL) (p = 0.021). Also, positive correlations were found between C-reactive protein (p = 0.003) and BASDAI (p = 0.009) with serum uric acid.
Conclusions: According to this study, we can consider that serum uric acid level could be used as an inflammatory laboratory marker, such as C-reactive protein in ankylosing spondylitis patients. However, we believe that more studies are needed about this research.
[1] Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci 2013;345:431-6.
[2] Choi HK, Mount DB, Reginato AM. Pathogenesis of gout. Ann Intern Med 2005;143: 499-516.
[3] Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa T, et al. Uric acid stimulate monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003;41:1287-93.
[4] Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.
[5] Oeckinghaus A, Ghosh S. The NF-kappaB family of transcription factors and its regulation. Cold Spring Harb Perspect Biol 2009;1:a000034.
[6] Choe JY, Kim SK. Association between serum uric acid and inflammation in rheumatoid arthritis: perspective on lowering serum uric acid of leflunomide. Clin Chim Acta 2015;438:29-34.
[7] Sheikh M, Movassaghi S, Khaledi M, Moghaddassi M. Hyperuricemia in systemic lupus erythematosus: is it associated with the neuropsychiatric manifestations of the disease? Rev Bras Reumatol Engl Ed 2016;56:471-77.
[8] Prasad PV, Bikku B, Kaviarasan PK, Senthilnathan A. A clinical study of psoriatic arthropathy. Indian J Dermatol Venereol Leprol 2007;73:166-70.
[9] Kwon HH, Kwon IH, Choi JW, Youn JI. Cross-sectional study on the correlation of serum uric acid with disease severity in Korean patients with psoriasis. Clin Exp Dermatol 2011;36:473-8.
[10] Gisondi P, Targher G, Cagalli A, Girolomoni G. Hyperuricemia in patients with chronic plaque psoriasis. J Am Acad Dermatol 2014;70:127-30.
[11] Li X, Miao X, Wang H, Wang Y, Li F, Yang Q, et al. Association of serum uric acid levels in psoriasis: a systematic review and meta-analysis. Medicine (Baltimore) 2016;95:e3676.
[12] Kanellis J, Kang DH. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol 2005;25:39-42.
[13] Isha VK, Lal JH. C-reactive protein and uric Acid levels in patients with psoriasis. Ind J Clin Biochem 2011;26:309-11.
[14] Lyngdoh T, Marques-Vidal P, Paccaud F, Preisig M, Waeber G, Bochud M, et al. Elevated serum uric acid is associated with high circulating inflammatory cytokines in the population-based Colaus study. PLoS One 2011;6:e19901.
[15] Jiménez Balderas FJ, Robles EJ, Juan L, Badui E, Arellano H, Espinosa Said L, et al. Purine metabolism in ankylosing spondylitis: clinical study. Arch Invest Med (Mex) 1989;20:163-70.
[16] Van Leeuwen AM, Bladh ML. Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications. 6th ed. Philadelphia, PA: PA. Davis Company, 2015., p.329.
[17] Nashel DJ, Petrone DL, Ulmer CC, Sliwinski AJ. C-reactive protein: a marker for disease activity in ankylosing spondylitis and Reiter's syndrome. J Rheumatol 1986;13:364-7.
[18] Benhamou M, Gossec L, Dougados M. Clinical relevance of C-reactive protein in ankylosing spondylitis and evaluation of the NSAIDs/coxibs' treatment effect on C-reactive protein. Rheumatology (Oxford) 2010;49:536-41.
[19] Siebuhr AS, Bay-Jensen AC, Karsdal MA, Lories RJ, de Vlam K. CRP and a biomarker of type I collagen degradation, C1M, can differentiate anti inflammatory treatment response in ankylosing spondylitis. Biomark Med 2016;10:197-208.

Copyright (c) 2019 The European Research Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Downloads
Article Information
- Article Type Research Article
- Submitted February 21, 2026
- Published January 3, 2019
- Issue Vol. 5 No. 1 (2019)
- Section Research Article