Abstract
BackgroundDyslipidemia often concurs with hyperuricemia. Our study was to discover different lipid levels of gout and asymptomatic hyperuricemia and the predictors of sUA (serum uric acid) levels.MethodsA cross-sectional study was performed to collect demographic, clinical variables, comorbidities and laboratory testing in patients with gout and asymptomatic hyperuricemia. Group comparison was performed with Student’s t-test or Mann Whitney U test for continuous variables and chi-squared tests for categorical variables (Fisher’s exact test where appropriate) and to screen potential risk factors. Correlation of sUA levels with demographic and biochemical variables were performed by using correlation analysis. The variable with s p-value less than 0.20 during the group comparison or clinical relevance was introduced into the stepwise multiple regression model.ResultsSix hundred fifty-three patients with gout and 63 patients with asymptomatic hyperuricemia (> 420 μmol/L in male and > 360 μmol/L in female) were enrolled, including 553 (84.7%) males. The mean age was 47.8 ± 16.0 years old. Elevated total cholesterol (TC) was observed in 173 (26.5%) cases with gout. Increased triglycerides (TG) and low-density lipoprotein (LDL-C) levels were observed in 242 (37.1%) cases and 270 (41.3%) cases with gout, individually. In contrast, elevated TC, TG and LDL-C levels were observed in 10 (15.9%) cases, 30 (47.6%) cases and 22 (34.9%) cases with hyperuricemia, individually. Significant differences were found in age, serum creatine, TC and erythrocyte sedimentation rate (ESR) between gout and asymptomatic hyperuricemia groups (p < 0.05). In patients with asymptomatic hyperuricemia, 12 (19.0%) patients had hypertension and 5 (7.9%) suffered from coronary heart diseases. Male (B = -112.7, p < 0.001), high-density lipoprotein (HDL-C) (B = -60.797, p = 0.013), body mass index (BMI) (B = 5.168, p = 0.024), age (B = -3.475, p = 0.006), age of hyperuricemia onset (B = 2.683, p = 0.032), and serum creatine (B = 0.534, p < 0.001) were predictors of sUA levels in gout patients (adjusted R2 = 28.7%).ConclusionsDyslipidemia is more commonly seen in patients with gout, compared to asymptomatic hyperuricemia. HDL-C is a protective predictor of sUA levels in gout.
Highlights
Gout is a chronic inflammatory disease characterized by recurrent joint inflammation and dysfunction caused by purine metabolism imbalance and elevated serum uric acid whose prevalence continues to go up worldwide
Our study proved a high prevalence of cardiovascular diseases as a comorbidity of gout and asymptomatic hyperuricemia
As cardiovascular comorbidities are frequently seen in patients with gout and play an important role in the premature mortality, patients with both gout and asymptomatic hyperuricemia should be systematically screened for cardiovascular diseases and risk factors, which should be addressed as an essential part of gout and hyperuricemia management
Summary
Gout is a chronic inflammatory disease characterized by recurrent joint inflammation and dysfunction caused by purine metabolism imbalance and elevated serum uric acid (sUA) whose prevalence continues to go up worldwide. As a chronic systemic inflammatory disease, gout often concurs with comorbidities such as dyslipidemia, cardiovascular disease, fatty liver disease, and renal disease [1, 2]. Over the last two decades, in gout patients, the association of hyperuricemia with cardiovascular risk factors has been testified following the demonstration in animal models [4] and human studies [3, 5]. A few studies have been conducted to investigate the association between sUA and lipid profiles in the gout population, their association in the subjects with asymptomatic hyperuricemia hasn’t been thoroughly investigated. Our study was to discover different lipid levels of gout and asymptomatic hyperuricemia and the predictors of sUA (serum uric acid) levels
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