Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Author(s): Binit Vaidya*, Rikesh Baral, Lakpa Dolma Lama, Rakshya Joshi, Manisha Bhochhibhoya and Shweta Nakarmi

DOI: 10.2174/1871530320999200818141032

DownloadDownload PDF Flyer Cite As
A Study of Metabolic Parameters in Patients with Gout: A Single Center Study from Nepal

Page: [1090 - 1095] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

Background and Aims: To study the prevalence of deranged metabolic parameters in patients with gout.

Methods: This was a prospective, cross-sectional observational study conducted at a tertiary level rheumatology center in Nepal. Patients over 18 years and diagnosed as gout using the ACR/EULAR 2015 classification criteria were included in the study. Known cases of chronic kidney disease, liver disease and heart diseases were excluded. Baseline demographic data along with records of weight, waist circumference, lipid profile, glucose profile, blood pressure measurement, serum uric acid level and inflammatory markers were taken. Diagnosis of metabolic syndrome (MS) was made according to the National Cholesterol Education Program criteria. Approval was obtained from the ethical review board of the National Center for Rheumatic Diseases.

Results: A total of 523 patients with gout were enrolled in the study, out of which 97.0% were male. The mean age at diagnosis was 49.1±12.8 years. Most of the patients were overweight with a mean BMI of 27.0±3.6 kg/m2. About 8.1% had preexisting diabetes mellitus, 24.6% had hypertension, 5.1% had hypothyroidism and 45.1% had dyslipidemia. Patients fulfilling 2 out of 5 criteria of MS were 60.6% whereas 30.6% fulfilled 3 out of 5 criteria.

Conclusion: Gout was commonly observed in middle-aged men. The prevalence of metabolic syndrome and its components was high in patients with gout. Management of gout should also include screening and management of the metabolic syndrome.

Keywords: Gout, metabolic syndrome, Nepal, uric acid, body mass index, lipid profile.

Graphical Abstract

[1]
Ragab, G.; Elshahaly, M.; Bardin, T. Gout: An old disease in new perspective - A review. J. Adv. Res., 2017, 8(5), 495-511.
[http://dx.doi.org/10.1016/j.jare.2017.04.008] [PMID: 28748116]
[2]
Pickens, S.R.; Chamberlain, N.D.; Volin, M.V.; Pope, R.M.; Talarico, N.E.; Mandelin, A.M., II; Shahrara, S. Characterization of interleukin-7 and interleukin-7 receptor in the pathogenesis of rheumatoid arthritis. Arthritis Rheum., 2011, 63(10), 2884-2893.
[http://dx.doi.org/10.1002/art.30493] [PMID: 21647866]
[3]
Elfishawi, M.M.; Zleik, N.; Kvrgic, Z.; Michet, C.J., Jr; Crowson, C.S.; Matteson, E.L.; Bongartz, T. The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years. J. Rheumatol., 2018, 45(4), 574-579.
[http://dx.doi.org/10.3899/jrheum.170806] [PMID: 29247151]
[4]
Kuo, C.F.; Grainge, M.J.; Zhang, W.; Doherty, M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat. Rev. Rheumatol., 2015, 11(11), 649-662.
[http://dx.doi.org/10.1038/nrrheum.2015.91] [PMID: 26150127]
[5]
Choi, H.K.; Ford, E.S. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am. J. Med., 2007, 120(5), 442-447.
[http://dx.doi.org/10.1016/j.amjmed.2006.06.040] [PMID: 17466656]
[6]
Sui, X.; Church, T.S.; Meriwether, R.A.; Lobelo, F.; Blair, S.N. Uric acid and the development of metabolic syndrome in women and men. Metabolism, 2008, 57(6), 845-852.
[http://dx.doi.org/10.1016/j.metabol.2008.01.030] [PMID: 18502269]
[7]
Ryu, S.; Song, J.; Choi, B.Y.; Lee, S.J.; Kim, W.S.; Chang, Y.; Kim, D.I.; Suh, B.S.; Sung, K.C. Incidence and risk factors for metabolic syndrome in Korean male workers, ages 30 to 39. Ann. Epidemiol., 2007, 17(4), 245-252.
[http://dx.doi.org/10.1016/j.annepidem.2006.10.001] [PMID: 17300957]
[8]
Kim, S-K. Interrelationship of Uric Acid, Gout, and Metabolic Syndrome: Focus on Hypertension, Cardiovascular Disease, and Insulin Resistance. J. Rheum. Dis., 2018, 25(1), 19-27.
[http://dx.doi.org/10.4078/jrd.2018.25.1.19]
[9]
Choi, H.K.; Ford, E.S.; Li, C.; Curhan, G. Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum., 2007, 57(1), 109-115.
[http://dx.doi.org/10.1002/art.22466] [PMID: 17266099]
[10]
Neogi, T.; Jansen, T.L.T.A.; Dalbeth, N.; Fransen, J.; Schumacher, H.R.; Berendsen, D.; Brown, M.; Choi, H.; Edwards, N.L.; Janssens, H.J.E.M.; Lioté, F.; Naden, R.P.; Nuki, G.; Ogdie, A.; Perez-Ruiz, F.; Saag, K.; Singh, J.A.; Sundy, J.S.; Tausche, A-K.; Vaquez-Mellado, J.; Yarows, S.A.; Taylor, W.J. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis., 2015, 74(10), 1789-1798.
[http://dx.doi.org/10.1136/annrheumdis-2015-208237] [PMID: 26359487]
[11]
Zhang, M.L.; Gao, Y.X.; Wang, X.; Chang, H.; Huang, G.W. Serum uric acid and appropriate cutoff value for prediction of metabolic syndrome among Chinese adults. J. Clin. Biochem. Nutr., 2013, 52(1), 38-42.
[http://dx.doi.org/10.3164/jcbn.12-65] [PMID: 23341696]
[12]
Rezaianzadeh, A.; Namayandeh, S.M.; Sadr, S.M. National Cholesterol Education Program Adult Treatment Panel III Versus International Diabetic Federation Definition of Metabolic Syndrome, Which One is Associated with Diabetes Mellitus and Coronary Artery Disease? Int. J. Prev. Med., 2012, 3(8), 552-558.
[PMID: 22973485]
[13]
Rho, Y.H.; Choi, S.J.; Lee, Y.H.; Ji, J.D.; Choi, K.M.; Baik, S.H.; Chung, S.H.; Kim, C.G.; Choe, J.Y.; Lee, S.W.; Chung, W.T.; Song, G.G. The prevalence of metabolic syndrome in patients with gout: a multicenter study. J. Korean Med. Sci., 2005, 20(6), 1029-1033.
[http://dx.doi.org/10.3346/jkms.2005.20.6.1029] [PMID: 16361817]
[14]
Brand, F.N.; McGee, D.L.; Kannel, W.B.; Stokes, J., III; Castelli, W.P. Hyperuricemia as a risk factor of coronary heart disease: The Framingham Study. Am. J. Epidemiol., 1985, 121(1), 11-18.
[http://dx.doi.org/10.1093/oxfordjournals.aje.a113972] [PMID: 3964986]
[15]
Lawrence, R.C.; Helmick, C.G.; Arnett, F.C.; Deyo, R.A.; Felson, D.T.; Giannini, E.H.; Heyse, S.P.; Hirsch, R.; Hochberg, M.C.; Hunder, G.G.; Liang, M.H.; Pillemer, S.R.; Steen, V.D.; Wolfe, F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum., 1998, 41(5), 778-799.
[http://dx.doi.org/10.1002/1529-0131(199805)41:5<778::AID-ART4>3.0.CO;2-V] [PMID: 9588729]
[16]
Roddy, E.; Doherty, M. Epidemiology of gout. Arthritis Res. Ther., 2010, 12(6), 223.
[http://dx.doi.org/10.1186/ar3199] [PMID: 21205285]
[17]
Singh, J.A. Racial and gender disparities among patients with gout. Curr. Rheumatol. Rep., 2013, 15(2), 307.
[http://dx.doi.org/10.1007/s11926-012-0307-x] [PMID: 23315156]
[18]
MacFarlane, L.A.; Kim, S.C. Gout: a review of nonmodifiable and modifiable risk factors. Rheum. Dis. Clin. North Am., 2014, 40(4), 581-604.
[http://dx.doi.org/10.1016/j.rdc.2014.07.002] [PMID: 25437279]
[19]
Sharma, S.K.; Ghimire, A.; Radhakrishnan, J.; Thapa, L.; Shrestha, N.R.; Paudel, N.; Gurung, K.; R, M.; Budathoki, A.; Baral, N.; Brodie, D. Prevalence of hypertension, obesity, diabetes, and metabolic syndrome in Nepal. Int. J. Hypertens., 2011, 2011, 821971.
[http://dx.doi.org/10.4061/2011/821971] [PMID: 21629873]
[20]
Vázquez-Mellado, J.; García, C.G.; Vázquez, S.G.; Medrano, G.; Ornelas, M.; Alcocer, L.; Marquez, A.; Burgos-Vargas, R. Metabolic syndrome and ischemic heart disease in gout. J. Clin. Rheumatol., 2004, 10(3), 105-109.
[http://dx.doi.org/10.1097/01.rhu.0000129082.42094.fc] [PMID: 17043480]
[21]
Huang, Y.; Guo, P.; Karmacharya, B. M.; Seeruttun, S. R.; Xu, D. R.; Hao, Y. Prevalence of hypertension and prehypertension in Nepal: a systematic review and meta-analysis. Global health research and policy, 2019, 4(11)
[22]
Poudel, B.; Yadav, B.K.; Kumar, A.; Jha, B.; Raut, K.B. Serum uric acid level in newly diagnosed essential hypertension in a Nepalese population: a hospital based cross sectional study. Asian Pac. J. Trop. Biomed., 2014, 4(1), 59-64.
[http://dx.doi.org/10.1016/S2221-1691(14)60209-4] [PMID: 24144132]
[23]
Lin, C.S.; Lee, W.L.; Hung, Y.J.; Lee, D.Y.; Chen, K.F.; Chi, W.C.; Chang, S.C. Prevalence of hyperuricemia and its association with antihypertensive treatment in hypertensive patients in Taiwan. Int. J. Cardiol., 2012, 156(1), 41-46.
[http://dx.doi.org/10.1016/j.ijcard.2010.10.033] [PMID: 21095025]
[24]
Tiwaskar, M. Hypertension and Hyperuricemia: A Compelling Correlation. J. Assoc. Physicians India, 2018, 66(1), 11-12.
[PMID: 30341838]
[25]
Lee, J.J.; Ahn, J.; Hwang, J.; Han, S.W.; Lee, K.N.; Kim, J.B.; Lee, S.; Na, J.O.; Lim, H.E.; Kim, J.W.; Rha, S.W.; Park, C.G.; Seo, H.S.; Oh, D.J.; Kim, E.J. Relationship between uric acid and blood pressure in different age groups. Clin. Hypertens., 2015, 21, 14.
[http://dx.doi.org/10.1186/s40885-015-0022-9] [PMID: 26893924]
[26]
Ali, N.; Mahmood, S.; Islam, F. Relationship between serum uric acid and hypertension: a cross-sectional study in Bangladeshi adults 2019, 9(1), 9061.
[http://dx.doi.org/10.1038/s41598-019-45680-4]
[27]
Dao, H.H.; Harun-Or-Rashid, M.; Sakamoto, J. Body composition and metabolic syndrome in patients with primary gout in Vietnam. Rheumatology (Oxford), 2010, 49(12), 2400-2407.
[http://dx.doi.org/10.1093/rheumatology/keq274] [PMID: 20817682]
[28]
Lee, W.Y.; Park, J.S.; Noh, S.Y.; Rhee, E.J.; Kim, S.W.; Zimmet, P.Z. Prevalence of the metabolic syndrome among 40,698 Korean metropolitan subjects. Diabetes Res. Clin. Pract., 2004, 65(2), 143-149.
[http://dx.doi.org/10.1016/j.diabres.2003.12.007] [PMID: 15223226]
[29]
Bonora, E.; Targher, G.; Zenere, M.B.; Saggiani, F.; Cacciatori, V.; Tosi, F.; Travia, D.; Zenti, M.G.; Branzi, P.; Santi, L.; Muggeo, M. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study. Int. J. Obes. Relat. Metab. Disord., 1996, 20(11), 975-980.
[PMID: 8923153]
[30]
Moreira, G.C.; Cipullo, J.P.; Ciorlia, L.A.; Cesarino, C.B.; Vilela-Martin, J.F. Prevalence of metabolic syndrome: association with risk factors and cardiovascular complications in an urban population. PLoS One, 2014, 9(9), e105056.
[http://dx.doi.org/10.1371/journal.pone.0105056] [PMID: 25180496]