[Analysis of early renal damage markers under different renal ultrasonic manifestations in gout patients]

Objective: To observe the relationship between early renal damage markers and renal ultrasonic manifestations in gout patients, and whether early renal damage is reversible after uric acid-reducing treatment. Methods: The gout patients from the Department of Rheumatology of Beijing Haidian Hospital and Peking University People's Hospital between July 2016 and December 2017 were recruited in this study. According to the results of renal ultrasonography, the patients were divided into the following three groups. Group A was normal. Group B was punctate crystallization. Group C was renal calculi. Each group included 30 patients. The patients in group B and group C who could insist on regular uric acid-reducing treatment for one year were selected. The levels of urinary RBP, β(2)-MG and NAG were measured in different groups and one year before and after uric acid-reducing treatment. Results: The urinary concentration of β(2)-MG in group A, group B and group C were (128.59±107.32), (316.08±207.41) and (311.25±162.85)mg/L, respectively. There were significant differences among the three groups (P<0.001). The urinary concentration of NAG were (13.41±5.12)U/L,(17.88±6.19)U/L and (18.48±9.84)U/L, respectively. There were differences among the three groups (P<0.01).There was no significant difference in urinary RBP concentration among the three groups (P=0.188). After one year of uric acid-reducing treatment, the levels of urinary RBP, β(2)-MG and NAG were lower than that before treatment. There were significant differences before and after treatment in each group (P<0.05). Compared with group C, the levels of urinary β(2)-MG and NAG were decreased in group B after uric acid-reducing treatment (all P<0.05). Conclusions: Renal ultrasonography is helpful for the diagnosis of early renal damage in gout patients. Early renal damage markers in gout patients decreased after uric acid-reducing treatment, suggesting that early renal damage can be reversible if early diagnosis and timely treatment can be made in gout patients.

[Comparison of bone destruction markers in patients with gouty arthritis under different musculoskeletal ultrasonic manifestations]

Objectives: To observe the correlation between the different ultrasonic manifestations of gouty arthritis and the indexes of bone destruction (Dickkopf-1, RANKL), in order to further explore the role of musculoskeletal ultrasonography in the diagnosis and monitoring of gouty arthritis. Methods: 160 cases of gouty arthritis from clinic of the Department of Rheumatology of Peking University People's Hospital between July 2016 and June 2017 were recruited in this study. These patients were examined by musculoskeletal ultrasonography (bilateral first metatarsophalangeal joints, bilateral ankle joints and bilateral knee joints). Grouping was based on ultrasound features of joints. Group A showed no aggregate .Group B showed aggregate and double contour signs. Group C showed tophus and bone erosion. Serum concentrations of Dickkopf-1 and RANKL were measured. The correlations of Dickkopf-1 or RANKL and clinical/laboratory parameters were analyzed. Results: (1)There was a significant difference in Dickkopf-1 concentration between the three groups(P<0.001). And the group C[(1 722.2±482.7)ng/L]was higher than the group B[(1 309.3±496.4)ng/L](t=4.418, P<0.001), and the group B was higher than group A[(807.9±373.8)ng/L](t=6.137, P<0.001). (2)There was a significant difference in RANKL concentration between the three groups (P<0.001). And the group C[(0.78±0.47)ng/L]was higher than the group B[(0.35±0.29)ng/L](t=5.456, P<0.001), and the group B was higher than group A[(0.10±0.09)ng/L](t=6.923, P<0.001). (3)The level of Dickkopf-1 was associated with the disease duration(r=0.430, P<0.001), and the level of RANKL was associated with the disease duration(r=0.359, P<0.001). Conclusion: Aggregates, double contour signs, tophus and bone erosion can be observed in the ultrasonic examination of gouty arthritis. And the longer the duration of the disease, the more likely the extent of bone destruction is. Joint ultrasound can be the first imaging examination for the extent of joint involvement in gouty arthritis. And the longer the duration of the disease, the more likely the extent of bone destruction is. Musculoskeletal ultrasonography can be the preferred imaging method for detecting the extent of joint involvement in gouty arthritis.