Association Between Uric Acid and Worsening Peripheral Microangiopathy in Systemic Sclerosis

Eleni Pagkopoulou; Stergios Soulaidopoulos; Eva Triantafyllidou; Afrodite Malliari; George D Kitas; Alexandros Garyfallos; Theodoros Dimitroulas

doi:10.3389/fmed.2021.806925

Association Between Uric Acid and Worsening Peripheral Microangiopathy in Systemic Sclerosis

Front Med (Lausanne). 2021 Dec 24:8:806925. doi: 10.3389/fmed.2021.806925. eCollection 2021.

Authors

Eleni Pagkopoulou¹, Stergios Soulaidopoulos², Eva Triantafyllidou¹, Afrodite Malliari³, George D Kitas^{4

5}, Alexandros Garyfallos¹, Theodoros Dimitroulas¹

Affiliations

¹ Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
² First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
³ International Hellenic University, Thessaloniki, Greece.
⁴ Department of Rheumatology, Dudley Group of Hospitals, NS Foundation Trust, Dudley, United Kingdom.
⁵ Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, United Kingdom.

Abstract

Objective: The key element in the pathogenesis of systemic sclerosis (SSc) is microcirculatory changes in several vascular beds. Uric acid is associated with endothelial dysfunction and therefore, microvascular damage. The aim of this study was to examine the association between uric acid (UA) and peripheral microvascular involvement in patients with SSc. Methods: We included consecutive, consenting patients with SSc. Serum UA, urea and creatinine were measured, and glomerular filtration rate (GFR) was calculated with CKD-EPI. All participants underwent nailfold video-capillaroscopy (NVC) to evaluate the microcirculation. Results: A total of 64 patients (95.3% women) were included in the study. UA levels were significantly associated with the number of avascular areas (r = 0.290; p = 0.020), whereas no correlation was shown for the GFR (r = -0.065; p = 0.609). A significant trend of UA in the three capillaroscopic patterns was shown (3.90 ± 1.52 vs. 4.15 ± 0.98 vs. 5.38 ± 2.26; for early, active, and late patterns respectively, p = 0.028). Multivariate analysis showed that male gender (β = 3.049; 95% CI = 0.997-5.101) and UA (β = 0.352; 95% CI = 0.117-0.588) were independently associated with the number of avascular areas. Conclusion: These data suggest that UA levels are significantly associated with the capillaroscopic patterns, reflecting a progressive microvasculopathy.

Keywords: cardiovascular; microvasculopathy; nailfold video-capillaroscopy; systemic sclerosis; uric acid.