Abstract
Primary gout is commonly associated with other metabolic disorders such as obesity, arterial hypertension, hyperlipidemia and diabetes mellitus that usually require a dietary regimen. However, long-term compliance to dietary restrictions may be rejected by subjects with a chronic disease and a peculiar tendency for purine-rich food. Among 175 patients with primary gout, 133 (76%) had associated metabolic disorders: 75 were obese (43%), 63 had arterial hypertension (36%), 67 showed hypercholesterolemia or hypertriglyceridemia (38%) and 10 had diabetes mellitus (6%). Besides gout, 42 patients (24%) had no other metabolic derangements requiring dietary intervention. In these patients a purine-restricted diet (< 75 mg/24 h of purines) for 5 days diminished the serum urate concentration from a base-line value of (mean±SEM) 8.9±0.2 to 7.2±0.2 mg/dl (P< 0.001) and uric acid excretion from 792±53 to 478±29 mg/24 h (P < 0.001). The administration of allopurinol (300 mg/24 h) for 5 days, while patients were on a self-selected diet, reduced serum urate to 5.4±0.1 mg/dl (P<0.001) and uric acid excretion to 374±22 mg/24h (P<0.001). These data indicate that allopurinol normalises uric acid metabolism in patients with primary gout who had no associated metabolic disorders, despite the intake of a self-selected diet.
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