Serum Uric Acid Levels in Patients With Benign Paroxysmal Positional Vertigo (BPPY): a Case-control Study at Kenyatta National Hospital

Abstract

Background: Benign paroxysmal positional vertigo (BPPV)is a peripheral vestibular disorder that contribute to dizziness and falls among afflicted patients. BPPV negatively affects the quality of life as it interferes with the patient's ability to perform daily activities. Serum uric acid levels have been linked as a risk factor for BPPV however there is no conclusive evidence on this causative relationship. Objective: To compare the serum uric acid levels in patients with BPPV and controls in Kenyatta National Hospital. Study Design and setting: This was a case-control study at the Ear, Nose and Throat clinic and the blood transfusion unit in Kenyatta National Hospital Study population: The study involved a total of 33 cases aged 18 years and above diagnosed with BPPV and 33 age and sex-matched controls without a history of Vertigo at KNH from July 2022 to February 2023 Methodology: Patients diagnosed with BPPV through history and examination via the Dix Hallpike maneuver for posterior and anterior canal BPPV and supine roll test for lateral canal BPPV were included in the study. Serum uric acid level was determined. The process was repeated for the age and sex-matched controls drawn from the blood transfusion unit. Data Analysis: Data was analyzed using STATA version 17. Continuous data was summarized using median (IQR). Categorical variables were summarized using frequencies and percentages. Rank sum test was used to compare medians of continuous data between cases and controls. Multiple conditional logistic regression was used to determine the association between BPPV and Serum uric acid (SUA) levels. Adjusted odds ratio (aOR) and the corresponding 95% confidence interval and p-value were reported. Results: Most BPPV patients were female (70%) aged 30-56 years. The median serum uric acid levels were decreased in patients with BPPV compared to controls (224.5 umol/l vs

257.7umol/L) although the difference was not significant(p=0.350). There was no significant association between SUA levels and BPPV at a 5% significance level (aOR=0.997; 95% CI: 0.989, 1.005). The most common diagnosis was the right posterior semicircular canal BPPV with a prevalence of 73%. Conclusion: This study showed that BPPV had a female preponderance in the ratio of 2.3:1. There was no significant difference in serum uric acid levels between cases and controls.