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Association between musculoskeletal ultrasonography and bone remodelling markers and its role in disease monitoring of gout and hyperuricaemia


1, 2, 3, 4, 5, 6, 7, 8

 

  1. Department of Rheumatology and Immunology, Peking University International Hospital, and Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
  2. Department of Rheumatology and Immunology, Peking University People’s Hospital, and Department of Rheumatology and Immunology, Beijing Haidian Hospital (Beijing Haidian Section of Peking University Third Hospital), Beijing, China.
  3. Department of Rheumatology and Immunology, Peking University International Hospital, and Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
  4. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
  5. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
  6. Department of Ultrasound, Peking University People’s Hospital, Beijing, China.
  7. Department of Orthopaedics, The Hospital of Renmin University of China, Beijing, China.
  8. Department of Rheumatology and Immunology, Peking University International Hospital, and Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China. xuewulore@163.com

CER12545
2020 Vol.38, N°5
PI 0896, PF 0902
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PMID: 31858958 [PubMed]

Received: 29/06/2019
Accepted : 01/10/2019
In Press: 19/12/2019
Published: 02/10/2020

Abstract

OBJECTIVES:
To evaluate associations between bone destruction markers and musculoskeletal ultrasonography (MU) findings in patients with gout and hyperuricaemia and clarify the role of MU in treatment responsiveness.
METHODS:
One-hundred and fifty patients with gout and 100 patients with hyperuricaemia were divided into five groups according to MU manifestations. Circulating Dickkopf-1 (DKK-1) and receptor activator of nuclear factor-κB ligand (RANKL) levels were measured. Thirty patients from the gout group and 10 from the hyperuricaemia group, were treated for 1 year with urate-lowering therapy (ULT).
RESULTS:
Patients with gout and tophus and/or bone erosion had the highest DKK-1 and RANKL levels. Patients with gout and MU-evidenced aggregates and/or double-contour signs had higher DKK-1 and RANKL levels than the normal MU group (p<0.001). Patients with hyperuricaemia and abnormal MU findings had significantly higher DKK-1 and RANKL levels than those with normal MU findings. DKK-1 and RANKL levels positively correlated with disease duration in patients with gout (r=0.430, p<0.001; r=0.359, p<0.001, respectively) and hyperuricaemia (r=0.446, p<0.001; r=0.379, p<0.001, respectively). After ULT, MU abnormalities disappeared in 12 and 8 patients with gout and hyperuricaemia, respectively. The largest tophus diameter decreased in patients with gout (t=6.092, p<0.001). DKK-1 and RANKL concentrations significantly decreased in all patients. Lower serum urate levels corresponded with higher ratios of normal MU features in all patients.
CONCLUSIONS:
In patients with gout and hyperuricaemia, MU manifestations were associated with DKK-1 and RANKL levels and were ameliorated after ULT. Thus, MU could be a useful tool in assessing bone remodelling and monitoring disease responsiveness.

Rheumatology Article