Hyperuricemia in psoriatic arthritis - Prevalence and associated features

We aimed to assess the prevalence of hyperuricemia in a cohort of patients with psoriatic arthritis (PsA) and to determine the influence of skin invol vement on serum uric acid (SUA) levels. Patients followed at the University of Toronto Psoriatic Arthritis clinic from 1991-1997 were studied. Those w ho developed hyperuricemia (SUA >450 mu mol/L for males or >360 mu moI/L fo r females) and the next 3 normouricemic PsA patients were studied. Skin inv olvement was assessed using the Psoriasis Area and Severity index score. Of 265 patients, 55 (20.7%) had less than or equal to 1 episode of hyperurice mia. There was no association between Psoriasis Area and Severity index sco re and SUA. In multivariate analysis, the best predictors of hyperuricemia were elevated serum creatinine and elevated total cholesterol. One or both values were elevated in 70.9% of patients with hyperuricemia and 35.2% of c ontrols (p < 0.001. SUA in PsA is not associated with the extent of skin in volvement but reflects metabolic changes, especially hypercholesterolemia a nd renal impairment.