Assessment of cardiovascular risk in patients with primary chronic gout combined with metabolic syndrome
Keywords:primary chronic gout, metabolic syndrome, uric acid, cardiovascular risk
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.
Sidiropoulos PI, Karvounaris SA, Boumpas DT. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology and clinical implications. Arthritis Res Ther. 2008;10(3):207. doi: 10.1186/ar2397.
Cherniaieva AA, Karachentsev YI, Kravchun NA, Tykhonova TM. Clinical and pathogenetic aspects of the purine metabolism state in diabetes mellitus (review of literature and own obser vations). Problemi endokrinnoi patologii. 2018;(4):75-84. (in Ukrainian).
Polskaya II, Marusenko IM, Kulagina TI, Vezikova NN. Occurrence of the metabolic syndrome and its effect on cardiovascular risk in patients with gout. Rational Pharmacotherapy in Cardiology. 2017;13(4):476-481. doi: 10.20996/1819-6446- 2017-13-4-476-481. (in Russian).
Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group.The metabolic syndrome: a new worldwide definition. Lancet. 2005 Sep 24-30;366(9491):1059-62. doi: 10.1016/S0140-6736(05) 67402-8.
Chmyr NV. Role of thyroid gland in metabolic syndrome and in combination with chronic coronary heart disease and type 2 diabetes mellitus. Mìžnarodnij endokrinologìčnij žurnal. 2018;14(8):740-743. doi: 10.22141/2224-07220.127.116.118.154853. (in Ukrainian).
Barskova VG, Eliseev MS, Nasonov EL, Yakunina IA, Zilov AV, Ilyinykh EV. Immunoresistance syndrome in gout patients and its influence on formation of clinical features of the disease. Terapevticheskiy arkhiv. 2004;76(5):51-56. (in Russian).
Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yü TF. Preliminary criteria for the classification of the acute arthritis of gout. Arthritis Rheum. 1977 Apr;20(3):895-900. doi: 10.1002/art.1780200320.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97. doi: 10.1001/jama.285.19.2486.
Klimov AN, Nikul'cheva IuG. Obmen lipidov i lipoproteidov i ikh narusheniia [The exchange of lipids and lipoproteins and their violations]. SPb; 1999. 505 p. (in Russian).
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national commit tо on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. et al. The seventh report of the joint national commit tо on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72. doi: 10.1001/jama.289.19.2560.
Medsoftpro. SCORE calculator. Available from: https://medsoftpro.ru/kalkulyatory/kalkulyator-score.html.
Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation. 2002 Jan 22;105(3):310-5.doi: 10.1161/hc0302.102575.
Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011 Oct;63(10):3136-41. doi: 10.1002/art.30520.
Yoo HG, Lee SI, Chae HJ, Park SJ, Lee YC, Yoo WH. Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis. Rheumatol Int. 2011 Apr;31(4):485-91. doi: 10.1007/s00296-009-1304-x.
Janssens HJ, van de Lisdonk EH, Bor H, van den Hoogen HJ, Janssen M. Gout, just a nasty event or a cardiovascular signal? A study from primary care. Fam Pract. 2003 Aug;20(4):413-6. doi: 10.1093/fampra/cmg413.
Krishnan E, Svendsen K, Neaton JD, Grandits G, Kuller LH; MRFIT Research Group. Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med. 2008 May 26;168(10):1104-10. doi: 10.1001/archinte.168.10.1104.
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