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Research Article
Angelo Gaffo
University of Alabama at Birmingham
Corresponding Author
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Background: Previous studies have noted significant variation in serum urate (sUA) levels, and it is unknown how this influences the accuracy of hyperuricemia classification based on single data points. Despite this known variability, hyperuricemic patients are often used as a control group in gout studies. Our objective was to determine the accuracy of hyperuricemia classifications based on single data points versus multiple data points given the degree of variability observed with serial measurements of sUA.
Methods: Data was analyzed from a cross-over clinical trial of urate-lowering therapy in young adults without a gout diagnosis. In the control phase, sUA levels used for this analysis were collected at 2-4 week intervals. Mean coefficient of variation for sUA was determined, as were rates of conversion between normouricemia (sUA ≤6.8 mg/dL) and hyperuricemia (sUA >6.8 mg/dL).
Results: Mean study participant (n = 85) age was 27.8 ± 7.0 years, with 39% female participants and 41% African-American participants. Mean sUA coefficient of variation was 8.5% ± 4.9% (1% to 23%). There was no significant difference in variation between men and women, or between participants initially normouricemic and those who were initially hyperuricemic.
Among those initially normouricemic (n=72), 15% converted to hyperuricemia during at least one subsequent measurement. The subgroup with initial sUA <6.0 (n=54) was much less likely to have future values in the range of hyperuricemia compared to the group with screening sUA values between 6.0-6.8 (n=18) (7% vs 39%, p = 0.0037).
Of the participants initially hyperuricemic (n=13), 46% were later normouricemic during at least one measurement.
Conclusion: Single sUA measurements were unreliable in hyperuricemia classification due to spontaneous variation. Those with an sUA of <6.0 mg/dL were less likely to demonstrate future hyperuricemic measurements and this could be considered a safer threshold to rule out intermittent hyperuricemia based on a single measurement point.
Trial registration: Data from parent study ClinicalTrials.gov Identifier: NCT02038179
Keywords
normouricemic, hyperuricemic, SURPHER
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CURRENT STATUS: Under Review
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Posted 08 Dec, 2020
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Editorial decision: Major revision
On 01 Feb, 2021
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Received 21 Jan, 2021
Reviewers agreed
On 13 Jan, 2021
Reviewers agreed
On 03 Jan, 2021
Reviewers invited
Invitations sent on 01 Dec, 2020
Editor assigned
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
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On 01 Dec, 2020
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On 24 Nov, 2020
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Subject Areas
Rheumatology
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A new preprint design is coming!
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This preprint is under consideration at BMC Rheumatology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Angelo Gaffo
University of Alabama at Birmingham
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 08 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 01 Feb, 2021
Reviews received
Received 21 Jan, 2021
Reviewers agreed
On 13 Jan, 2021
Reviewers agreed
On 03 Jan, 2021
Reviewers invited
Invitations sent on 01 Dec, 2020
Editor assigned
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
First submitted
On 24 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Previous studies have noted significant variation in serum urate (sUA) levels, and it is unknown how this influences the accuracy of hyperuricemia classification based on single data points. Despite this known variability, hyperuricemic patients are often used as a control group in gout studies. Our objective was to determine the accuracy of hyperuricemia classifications based on single data points versus multiple data points given the degree of variability observed with serial measurements of sUA.
Methods: Data was analyzed from a cross-over clinical trial of urate-lowering therapy in young adults without a gout diagnosis. In the control phase, sUA levels used for this analysis were collected at 2-4 week intervals. Mean coefficient of variation for sUA was determined, as were rates of conversion between normouricemia (sUA ≤6.8 mg/dL) and hyperuricemia (sUA >6.8 mg/dL).
Results: Mean study participant (n = 85) age was 27.8 ± 7.0 years, with 39% female participants and 41% African-American participants. Mean sUA coefficient of variation was 8.5% ± 4.9% (1% to 23%). There was no significant difference in variation between men and women, or between participants initially normouricemic and those who were initially hyperuricemic.
Among those initially normouricemic (n=72), 15% converted to hyperuricemia during at least one subsequent measurement. The subgroup with initial sUA <6.0 (n=54) was much less likely to have future values in the range of hyperuricemia compared to the group with screening sUA values between 6.0-6.8 (n=18) (7% vs 39%, p = 0.0037).
Of the participants initially hyperuricemic (n=13), 46% were later normouricemic during at least one measurement.
Conclusion: Single sUA measurements were unreliable in hyperuricemia classification due to spontaneous variation. Those with an sUA of <6.0 mg/dL were less likely to demonstrate future hyperuricemic measurements and this could be considered a safer threshold to rule out intermittent hyperuricemia based on a single measurement point.
Trial registration: Data from parent study ClinicalTrials.gov Identifier: NCT02038179
Figure 1
Figure 2
Figure 3
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