AB0886 IS THE SENSE OF SMELL IMPAIRED IN GOUT PATIENTS?

Abstract

Background The sense of smell is sensitive to hundreds of thousands of odorants. Smell disorders significantly compromise the quality of life. A National Health and Nutrition Examination Survey (NHANES) 2013-2014 survey among US population aged 40 years of age and older years found smell dysfunction in ∼ 20.5 million (13.5%) of Americans (1). Prevalence increased with age. Other factors influencing the sense of smell include ethnicity, smoking, medications, head trauma, chronic sinusitis, upper respiratory tract infections, alcoholism and neurological disorders. The University of Pennsylvania Smell Identification Test (UPSIT) (2) is a well-validated test of olfactory function that correlates with odor detection and other quantitative measures of olfaction. This test has become the ‘gold standard’ for olfactory testing and is comprised of four test booklets, each containing 10 microencapsulated (scratch & sniff) odors. Patients with gout, the most common inflammatory arthritis, frequently have multiple associated comorbidities, affecting many organs and aspects of one’s health. Objectives To determine whether gout patients have an impaired sense of smell. Methods This was a cross-sectional prospective study of gout patients seen in our rheumatology clinic. The first 30 clinic patients were recruited during the period 7/15/17-5/25/18. Each patient was administered the 40-item UPSIT. UPSIT scores were compared to age- and sex-matched controls from a normative database maintained at the University of Pennsylvania Smell and Taste Center using a paired t-test. Results Gout patients ranged in age from 31 - 86 years (mean: 59 years); 26 (87%) of patients were ≥ 40 years old and included 26 men and 4 women. The duration of gout ranged from 1- 43 years (mean: 9 years), with 19 having gout for >5 years. Visible tophi were observed in 6 patients (33%). C-reactive protein was within normal range except in one gout patient. Serum urate levels ranged from 5.1-12 mg/dL (mean: 6.29 mg/dL). Two patients were current smokers; both have microsomia. No patients had head trauma, chronic sinusitis, upper respiratory tract infections, alcoholism or neurological disorders. The mean UPSIT scores of the two groups did not differ significantly [respective patient and control means (SDs) = 31.40 (5.79) and 31.80 (4.37); t29 = -0.342, p = 0.74]. Conclusion This is the first study to quantitatively assess smell function in patients with gout. Despite being a systemic inflammatory disease, with multiple assocaited comorbidities, we did not find a statistically significant effect of gout on smell function using a well validated olfactory test.