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Dr.P.Kiranmai MD and Dr.Ramashouri MD


Introduction: Hydroxyproline is present almost entirely in collagen. Bone tissue pathologies are reflected in the metabolism of hydroxyproline as are articular connective tissue pathology .Hence the study was conducted to compare the levels of hydroxy proline in urine of patients of Rheumatoid arthritis and osteoarthritis to study if hydroxy proline urinary values can be used for differentiating the two conditions. Materials and Methods 25 normal healthy volunteers working in Gandhi Medical College participated in the study to form the control group. Study includes 50 cases of arthritis. Cases are divided into two groups. Group I includes 25 cases of established rheumatoid arthritis patients and Group II includes 25 cases of established osteo arthritis. Both control and study group persons were advised to have collagen free diet for two days. Hydroxy proline and creatinine are estimated in 24 hrs urine sample in control and study groups. Results: There is a statistically significant increase in hydroxy proline excretion in group I when compared to control group.(p<0.05). Hydroxyproline excretion is more in Group II when compared to control group but there is no statistical significance. (p>0.05). Excretion of hydroxyproline in group I cases is more than in Group II cases (p<0.05). There is a significant increase in urinary hydroxyprolinecreatinine ratio in GroupI when compared to group II (p <0.05). No significant change is observed in urinaryhydroxyprolinecreatinine ratio levels between control group and GroupII. Discussion: Hydroxy proline is present only in collagen and to a little extent in elastin. It's quantity therefore reflects the synthesis and breakdown of collagen or one of its precursors. Though it is focal, in cases of Rheumatoid arthritis collagen degeneration is sufficiently large in magnitude to increase the excretion of hydroxy proline in urine. In osteoarthritis no collagen is involved hence there is no significant increase in excretion of hydroxyproline. Conclusion: In the present study there is increase in excretion of hydroxyproline and increase in urine hydroxyl proline /urine creatinine ratio in cases of rheumatoid arthritis when compared to osteoarthritis cases.

Keywords: Rheumatoid arthritis, Osteoarthritis, Urine Hydroxyproline.

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