Abstract
Gout is one of the most frequent type of inflammatory arthritis in developed countries. The elevation of serum uric acid levels and the deposition of monosodium urate crystals in joints and/or soft tissues are the mechanisms of pathogenesis. Uric acid is a product of the metabolic cleavage of purine nucleotides and organ meats, beef, pork, and lamb, anchovies, sardines, herring, mackerel, scallops, gravy and beer are known to be very rich in purine. On the other hand, some of these foods are also the main sources of vitamin B12 (cyanocobalamin). As a chronic inflammatory arthritis corticosteroids are frequently prescribed for gout patients, meaning a higher risk for osteoporosis which may be blocked by daily calcium and vitamin D replacement. However, there are no recommendations about screening or replacement of Gout patients for vitamin D and B12. Herein, we evaluated our patients retrospectively to document their vitamin levels and also to find the factors associated with vitamin deficiency. Totally, 90 patients, 71 (79.9%) male and 19 (20.1%) female patients with a median diagnostic age of 55 (19 - 80) were included. Thirty six (40%) patients were newly diagnosed (group 1) but 54 (60%) patients had established diseases (group-2) with median disease duration of 36 (11-240) months. Nearly half (47.2%) of the patients in group-1 and 37% of the patients in group-2 had vitamin B 12 deficiency. Similarly, 38.9% in each group had vitamin D deficiency and 52.8% in group-1 and 44.4% in group-2 had vitamin D insufficiency. In conclusion, we strongly recommend routine screening and replacement of vitamin B12 and D for patients with Gout.
Highlights
Gout is one of the most frequent rheumatologic diseases in all over the world and in the developed countries gout is the most common type of chronic inflammatory arthritis [1]
The elevation of serum uric acid levels and the deposition of monosodium urate crystals in joints and/or soft tissues are the mechanisms of pathogenesis
Uric acid is a product of the metabolic cleavage of purine nucleotides and organ meats, beef, pork, and lamb, anchovies, sardines, herring, mackerel, scallops, gravy and beer are known to be very rich in purine
Summary
Gout is one of the most frequent rheumatologic diseases in all over the world and in the developed countries gout is the most common type of chronic inflammatory arthritis [1]. Some of these foods are the main sources of vitamin B12 (cyanocobalamin) which is necessary for DNA formation, hematopoiesis and for prevention of neuropathy. According to novel data nearly 30% of patients older than 50 years have vitamin B12 deficiency and Health Canada recommend fortified foods for these patients [5]. Gout is more common after fifth decade and diet is an important and routine approach in management of patients with Gout. There are no recommendations about screening vitamin B12 levels and replacement therapy [6]
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