Assessment of cardiovascular risk in patients with primary chronic gout combined with metabolic syndrome
Background. The purpose of the study is to ivestigate the frequency of metabolic syndrome (MS) and to assess the total cardiovascular risk in patients with primary chronic gout, depending on the presence of MS. Materials and methods. Eightytwo patients with primary chronic gout, diagnosed with the qualification criteria of S.J. Wallase et al., were examined. The basic group included patients with primary chronic gout with MS (n = 52), which accounted for 63.4 % of all surveyed persons. The MS was diagnosed by IDF criteria. The comparison group involved patients with MS, matched by sex and age (n = 46). Clinical (anthropometric parameters, blood pressure) and laboratory examination (level of fasting glycaemia, uric acid, lipid, oral glucose tolerance test) took into account the presence of cardiovascular disease in medical history and its complications, evaluated cardiovascular risk on SCORE and PROCAM scales. Results. The incidence of obesity in the study groups was 65.4 and 63.0 %, respectively. The frequency of additional MS criteria was high in both groups studied. Hypertension and hypertriglyceridemia were equally often diagnosed in patients with MS regardless of the presence of gouty arthritis (p < 0.01). At least one additional MS criterion was detected in all those patients surveyed. 28.8 % of patients in the basic group and 4.3% patients in the comparison group were diagnosed with all five additional MS criteria (p < 0.01). In the patients of the basic group more than three additional MS criteria were identified compared to the comparison group — 51.9 and 30.4 %, respectively. The total cardiovascular risk on SCORE and PROCAM scales in patients in the basic group was significantly higher than in the comparison group (p < 0.05 and p < 0.01, respectively). Conclusions. MS was diagnosed in 63.4 % of patients with primary chronic gout. The patients with primary chronic gout combined with MS have a higher total cardiovascular risk on SCORE and PROCAM scales compared to patients with MS only. Evaluation of MS criteria, together with the assessment of cardiovascular risk, can be used in routine clinical practice to stratify patients with primary chronic gout who need lifestyle modifications and/or differentiated approaches to medical treatment.
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