Iron overload* and hemochromatosis can lead to cirrhosis, diabetes, heart failure, and arthritis. Elevated uric acid, known to cause gout, is associated with non-alcoholic liver disease and cardiovascular disease. It is also suggested as a marker for iron overload.
One study has shown that ferritin increases as uric acid increases. The present study was done to explore this relationship and information was extracted from the National Health and Nutrition Examination Survey (NHANES). Ferritin levels are elevated in women over 200 ng/mL, and elevated in men above 300 ng/dL (consistent with iron overload). High levels of uric acid are over 7 mg/dL in men and over 6 mg/dL in women (consistent with gout).
Extensive interviews regarding arthritis, joint pain and disability were done in the NHANES. A variety of liver function and kidney function tests were done on the subjects.
A complicated analysis was done of NHANES results to see if patients with high uric acids and high ferritin levels had poor outcomes. Of the sample of people tested, 10.9% had high ferritin levels and 17.6% had high uric acid levels. Of the people with high uric acid, 20.7% had high ferritin. Of those with low uric acid, only 8.8% had high ferritin. High uric acid was found to be associated with elevated ferritin with or without arthritis or limitation of activity. Those with high uric acid and high ferritin also had higher liver enzymes were more likely to have protein in their urine.
The finding of this study that high uric acid is a marker of iron overload is important for early treatment. The presence of elevated uric acid and ferritin levels is associated with worse liver and kidney function than when only one of these markers is elevated. Hemachromatosis is a possibility in patients when uric acid levels are high or when gout is diagnosed. The cause of this relationship is not known at this time.
CONCLUSION: Elevated uric acid should be considered a risk factor for iron overload or hemochromatosis. Ferritin blood levels should be done.
NOTE: *Iron overload is increased absorption of iron over a long period of time, causing a buildup of iron in the organs of the body. Hemachromatosis is the name of the disease which results from iron overload and can be hereditary.
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