CMMM: serum uric acid measurement and correlation analysis in patients with thyroid-related eye diseases

Background: Thyroid-associated eye disease (TAO) is one of the most common orbital diseases, with the highest
incidence in adults.
It is generally considered an organ-specific autoimmune disease
associated with thyroid dysfunction.
Its clinical manifestations are mainly proptosis, upper eyelid contracture, diplopia, strabismus, optic nerve injury, etc
.
The TAO process is divided into two phases: the active phase and the stationary phase
.
Because different treatments are required at different stages of the disease, evaluating the activity of ophthalmopathy is important for the choice of treatment and the estimation of prognosis
.
At present, the evaluation of TAO activities is mainly based on the patient's symptoms and signs, as well as imaging examinations, which are easily influenced
by subjective factors such as the patient's own and ophthalmologist's work experience.
In recent years, some progress has been made in the study of laboratory parameters of TAO activity, and it has been reported that urinary glycosaminoglycans (uGAG) and serum uric acid (sUA) play an important role
in the evaluation of TAO activity.
UA is the end product
of purine metabolism in the human body.
sUA levels indicate a balance
between purine nucleotide metabolism breakdown and uric acid excretion.
sUA levels are considered independent predictors
of metabolic syndrome.
However, different reports have different conclusions, and the inspection method is time-consuming and difficult to apply
routinely.

Purpose
.
Objective To investigate the role of
serum uric acid in evaluating the mobility of patients with thyroid-related eye diseases.

Method
.
A total of 443 TAO patients hospitalized in our hospital from March 2016 to February 2021 were selected as the observation group
.
At the same time, 443 healthy subjects were selected as the control group
.
The observation groups were divided into active groups (n = 254) and inactive groups (n = 189)
according to the Clinical Activity Score (CAS).
According to the severity of TAO, patients were divided into mild group (201 cases), moderate to severe group (133 cases), and very severe group (109 cases).

The serum uric acid, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid-stimulating hormone (TSH), glycated hemoglobin (HbA1c) levels of each group were measured and analyzed
.

Results: The serum UA, FT3, FT4, TSH and HbA1c in the active group were significantly higher than those in the other two groups (P < 0:05), and there was no significant difference between the inactive group and the control group (P > 0:05).

In different disease severity groups, the serum UA level of patients in the active group was significantly higher than that in the inactive group and the control group (P < 0:05), and the serum UA level in the very severe, moderate and severe group and mild group decreased sequentially, and the difference was statistically significant (P < 0:05).

。 Pearson's analysis showed that UA was positively correlated with FT3, FT4, and HbA1c (r = 0:652, P = 0:031; r = 0:571, P = 0:042; r = 0:737, P = 0:024), negatively correlated with TSH levels (r = −0:137, P = 0:262).

UA in the inactive group was not associated with
FT3, FT4 and HbA1c levels.
UA detection showed an average sensitivity of 94.
3% and specificity of 85.
2%
for TAO activity.
There was no significant correlation between disease severity and serum UA in inactive patients (P = 0:135).

Disease severity in active patients was positively correlated with serum UA (P = 0:005).

1:CASUA、FT3、FT4、TSH、HbA1c
。

1:CASUA

2:CASUAFT3、FT4、TSH、HbA1c

3:TAOUA OC

2UA
。

Conclusion: UA can be used as a laboratory index for the clinical quantitative diagnosis of thyroid-associated eye disease (TAO), and can also be used as a parameter
for the presence of TAO activity.

Zhou J, Yu X, Lou Y, et al.
Detection and Correlation Analysis of Serum Uric Acid in Patients with Thyroid-Associated Ophthalmopathy Comput Math Methods Med 2022; 2022