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Higher blood hematocrit predicts hyperuricemia: a prospective study of 62,897 person-years of follow-up.

ABSTRACT: This prospective study aimed to investigate the relationship between higher hematocrit (Hct) level and hyperuricemia (HU) incidence. A total of 27,540 subjects were included. Baseline Hct was classified into four categories based on the quartile distribution of the study population. A cox proportional hazards regression was used to evaluate the risk of HU incidence across the Hct quartiles after adjusting a number of potential confounding factors. Out of the 62,897 person-years of follow-up, 2745 new cases of HU were developed. In models adjusted for known risk factors of HU, higher Hct was used to predict HU incidence independently in a graded manner (p = 0.02): compared with subjects in the lowest quartile, subjects in the highest quartile of Hct (hazard ratio = 1.20; 95% confidence interval: 1.03-1.41) were n20% more likely to develop HU. Sensitivity analysis indicated that the hazard ratios increased with the extension of the minimum follow-up interval. When the minimum follow-up interval was restricted to 4 years, subjects in the highest quartile of Hct were 70% more likely to develop HU, compared with the lowest quartile. Higher Hct, a routinely measured inexpensive biomarker was independently associated with the incidence of HU even within the normal range.

SUBMITTER: Zeng C

PROVIDER: S-EPMC4559718 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:As reliable biomarkers of disease activity are lacking, monitoring of therapeutic response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains a challenge. We sought to determine whether nerve ultrasound and electrophysiology scoring could close this gap. In CIDP patients (fulfilling EFNS/PNS criteria), we performed high-resolution nerve ultrasound to determine ultrasound pattern sum scores (UPSS) and predominant echotexture nerve conduction study scores (NCSS) as well as Medical Research Council sum scores (MRCSS) and inflammatory neuropathy cause and treatment disability scores (INCAT) at baseline and after 12 months of standard treatment. We retrospectively correlated ultrasound morphology with nerve histology when available. 72/80 CIDP patients featured multifocal nerve enlargement, and 35/80 were therapy-naïve. At baseline, clinical scores correlated with NCSS (r2?=?0.397 and r2?=?0.443, p?<?0.01), but not or hardly with UPSS (Medical Research Council sum scores MRCSS r2?=?0.013, p?=?0.332; inflammatory neuropathy cause and treatment disability scores INCAT r2?=?0.053, p?=?0.048). Longitudinal changes in clinical scores, however, correlated significantly with changes in both UPSS and NCSS (r2?=?0.272-0.414, p?<?0.0001). Combining nerve/fascicle size with echointensity and histology at baseline, we noted 3 distinct classes: 1) hypoechoic enlargement, reflecting active inflammation and onion bulbs; 2) nerve enlargement with additional hyperechogenic fascicles/perifascicular tissue in >?50% of measured segments, possibly reflecting axonal degeneration; and 3) almost no enlargement, reflecting "burned-out" or "cured" disease without active inflammation. Clinical improvement after 12 months was best in patients with pattern 1 (up to 75% vs up to 43% in pattern 2/3, Fisher's exact test p?<?0.05). Nerve ultrasound has additional value not only for diagnosis, but also for classification of disease state and may predict treatment response.

Project description:Background and aimsThe incidence of total knee arthroplasty (TKA) is increasing, especially among younger working-age patients. However, dissatisfaction rates in this population are higher than among older patients. The aim of this study was to assess the rates of dissatisfaction and persistent pain after TKA and to evaluate those factors that predict these outcomes.Material and methodsIn total, 186 patients undergoing unilateral TKA aged 65 years or less were enrolled into this prospective observational study with 2-year follow-up. To assess the outcome, the visual analogue scales regarding satisfaction and persistent pain at rest and during exercise were used. In addition, the association between patients´ demographics, radiographic severity of knee osteoarthritis (OA), patient-reported outcome measures (PROMs) and dissatisfaction and persistent pain were tested by univariate logistic regression analysis. Mild OA was defined as Kellgren-Lawrence (KL) grade 2 and severe OA as KL grade 3-4. Furthermore, multiple logistic regression analysis was also conducted to test statistically significant relations.ResultsAfter 2 years, 12 % (n = 23) of patients were dissatisfied with the outcome of TKA, 27 % (n = 50) reported persistent pain during exercise and 10 % (n = 18) at rest. Patients with mild knee OA were significantly more dissatisfied (28.6 %) than patients with more severe OA (8.7 %) (p = 0.003). Younger patients had an increased risk for both dissatisfaction and persistent pain. Apart from KOOS Quality of Life, poor preoperative KOOS subscores were also predictive for these outcomes.ConclusionMild radiographic knee OA was the main predicting factor for dissatisfaction after TKA. Thus, performing TKA for such patients should be carefully considered. Furthermore, these patients should be informed about the increased risk for dissatisfaction and the same seems to apply to younger patients. Interestingly, when TKA is performed for patients with more severe knee OA, the satisfaction rates seem to be somewhat higher than those previously reported.Trial registrationThe study was retrospectively registered with ClinicalTrials.gov (registration number NCT03233620 ) on 28 July 2017.

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Higher blood hematocrit predicts hyperuricemia: a prospective study of 62,897 person-years of follow-up.

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