Relationship between the intima-media complex thickness, the risk factors of cardiovascular diseases, and the level of C-reactive protein in gouty patients


Aim. To estimate a relationship between the intima-media thickness (TIM), cardiovascular risk (CVR) factors, and the level of C-reactive protein (CRP) in gouty patients.
Subjects and methods. Eighty-nine patients at an interattack interval were examined. The patients' mean age was 46.0 ± 11.4 years; the duration of the disease was 5.2 (3.0; 8.9) years. The traditional CVR factors were analyzed. Carotid ultrasound scanning was performed to detect vascular atherosclerotic lesion. The serum CRP concentration was measured by a highly sensitive immunonefelometric assay.
Results. According to the TIM, the patients were divided into 2 groups: 1) 37 patients with signs of carotid atherosclerotic lesion (TIM l 0.9 mm); 2) 52 patients with a TIM of less than 0.9 mm. The ages at the moment of examination and at the onset of the disease, the duration of the disease, as well as systolic blood pressure, and the risk of myocardial ischemia were greater in Group 1 than those in Group 2. In patients with atherosclerosis, the concentration of CRP was statistically significantly higher than that in patients without this condition.
Conclusion. By complementing the classical CVR factors, CRP may be a predictor of cardiovaskular diseases and their complications in patients with gout at an interattack interval.


  1. Насонова В. А., Барскова В. Г. Ранние диагностика и лечение подагры - научно обоснованное требование улучшения трудового и жизненного прогноза больных // Научн.-практ. ревматол. 2004; 1: 5-7.
  2. Ланг Г. Ф. Гипертоническая болезнь. М.; 1950.
  3. Гудцент Ф. (Gudzent F.) Подагра и ревматизм. Пер. с нем. М.; Л.; 1931.
  4. Мясников А. Л. Атеросклероз. М.; 1960.
  5. Тареев Е. М. Внутренние болезни. М.; 1956.
  6. Тареев Е. М. Гипертоническая болезнь. М.; 1948.
  7. Vague J. The degree of masculine differentiation of obesities, a factor determining predisposition to diabetes, atherosclerosis, gout and uric calculous disease. Am. J. Clin. Nutr. 1956; 4 (2): 20-34.
  8. Myers A., Epstein F. H., Dodge H. J. et al. The relationship of serum uric acid to risk factors in coronary heart disease. Am. J. Med. 1968; 45: 520-528.
  9. Camus J. P. Goutte, diabete, hyperlipemie: un trisyndrom metabolique. Rev. Rhumatol. 1966; 33: 10-14.
  10. Барскова В. Г. Метаболический синдром и кардиоваскулярные нарушения при подагре: Автореф. дис. ... д-ра мед. наук. М.; 2006.
  11. Vázguez-Mellado J., Garsiá C. G., Vazguez S. G. et al. Metabolic syndrome and ischemic heart disease in gout. J. Clin. Rheumatol. 2004; 10 (3): 105-109.
  12. Gutman A. B. Views on the patоgenesis and management of primary gout - 1971. J. Bone Jt Surg. 1972; 54A: 357-372.
  13. Radic M. T., Valkenburg H. A., Davidson R. T. et al. Observations on the natural history of hyperuricemia and gout. I. An eighteen year follow-up of nineteen gouty families. Am. J. Med. 1964; 37: 862-871.
  14. Насонов Е. Л. Антифосфолипидный синдром. М.; 2004.
  15. Насонов Е. Л. Атеротромбоз при ревматических заболеваниях: анализ патогенеза. Тер. арх. 1998; 9: 92-95.
  16. Насонов Е. Л. Проблема атеротромбоза в ревматологии. Вестн. РАМН 2003; 7: 6-10.
  17. Ross R. Atherosclerosis - an inflammatory disease. N. Engl. J. Med. 1999; 340: 115-126.
  18. Du Clos TW. C - reactive protein as a regulator of autoimmunity and inflammation. Arthr. and Rheum. 2003; 48 (6); 1475-1477.
  19. Pepys M. B., Hirschfield G. M. C-reactive protein: a critical uptodate. J. Clin. Invest. 2003; 111: 1805-1808.
  20. Александрова Е. Н., Новиков А. А., Насонов Е. Л. Высокочувствительный метод определения С-реактивного белка (обзор литературы). Клин. лаб. диагн. 2004; 11: 16-18.
  21. Ockene I. S., Mathews C. D., Rifai N. et al. Validity and classification accuracy of serial high-sensitive C-reactive protein measurements in healthy adults. Clin. Chem. 2001; 47: 444-450.
  22. Rifai N., Tracy R. P., Pidker P. M. Clinical efficacy of an automated high-sensitivity C-reactive protein assay. Clin. Chem. 1999; 45: 2136-2141.
  23. Roberts W. L., Sedrick R., Moulton L. et al. Evaluation of four automated high-sensitive C-reactive protein methods; implications for clinical and epidemiological applications. Clin. Chem. 2000; 46: 461-468.
  24. Насонов Е. Л. Маркеры воспаления и атеросклероз: значение С-реактивного белка. Кардиология 1999; 2: 81-85.
  25. Насонов Е. Л., Панюкова Е. В., Александрова Е. Н. С-реактивный белок - маркер воспаления при атеросклерозе (новые данные). Кардиология 2002; 42 (7): 53-60.
  26. Albert M. A., Glynn R. J., Ridker P. M. Plasma concentration of C-reactive protein and the calculated Framingham coronary heart disease risk score. Circulation 2003; 108: 161-165.
  27. Ridker P. M. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 2003; 107: 363-369.
  28. Якунина И. А., Барскова В. Г., Лапкина Н. А. и др. Динамика уровня С-реактивного белка при подагрическом артрите. Науч.-практ. ревматол. 2005; 4: 38-41.
  29. McInnes I. B. Rheumatoid arthritis: from bench to bedside. Rheum. Dis. Clin. N. Am. 2001; 27: 373-387.
  30. Sattar N., McCarey D. W., Capel H. et al. Explaining how "high - grade" systemic inflamation accelerates vascular risk in rheumatoid arthritis. Circulation 2003; 108: 2957-2963.
  31. Goodson N. J., Symmons D. B. M., Scott D. G. I. et al. Baseline levels of C-reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis. Arthr. and Rheum. 2005; 52 (8): 2293-2299.
  32. Krishnan E., Baker J. F., Furst D. E., Schumacher H. R. Gout and the risk of acute myocardial infarction. Arthr. and Rheum. 2006; 54: 2688-2696.
  33. Mancini J. Carotid intima media thickness as a measure of vascular target organ damage. Curr. Hypertens. Rep. 2000; 2: 71-77.
  34. Bots M. L., Hoes A. W., Koudstaal P. J. et al. Common carotid intima-media thickness and risk of stroke and myocardial infarction. Circulation 1997; 96: 1432-1437.
  35. Wang T. J., Nam B.-H., Wilson P. W. F. et al. Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham Heart Study. Arterioscler. Thromb. Vasc. Biol. 2002; 22: 1662-1667.
  36. Cao J. J., Thach C., Manolio T. A. et al. C-reactive protein, carotid intima-media thickness, and incidence of ischemic stroke in the elderly. Circulation 2003; 108: 166-170.
  37. Tracy R. P., Lemaitre R. N., Psaty B. M. et al. Relationship study of C-reactive protein to risk of cardiovascular disease in the elderly: results from the Cardiovascular Health Study and the Rural Health Promotion Project. Arterioscler. Thromb. Vasc. Biol. 1997; 17: 1121-1127.
  38. O'Leary D. H., Polak J. F., Kronmal R. A. et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: Cardiovascular Health Study Collaborative Research Group. N. Engl. J. Med: 1999; 340: 14-22.
  39. Winbeck K., Kukla C., Poppert H. et al. Elevated C-reactive protein is associated with an increased intima to media thickness of the common carotid artery. Cerebrovasc. Dis. 2002; 13: 57-63.
  40. Hashimoto H., Kitagawa K., Hougaku H. et al. C-reactive protein is an independent predictor of the rate of increase in early carotid atherosclerosis. Circulation 2001; 104: 63-67.
  41. Wallace S. L., Robinson H., Masi A. T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthr. and Rheum. 1977; 20: 895-900.
  42. Wilson P. W. F., D'Agostino R. B., Levy D. et al. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97: 1837-1847.
  43. Артериальная гипертония (Рекомендации ВОЗ и МОАГ). М.: 1999. 18.
  44. Kannel W. B., Castelli W. P., McNamara M. P. The coronary profile: 12-year follow-up in Framingham Study. J. Occup. Med. 1967; 9 (12): 611-619.
  45. 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). Circulation 2002; 106: 3143.
  46. Перова Н. В. Суммарный риск ишемической болезни сердца и показания к лечению гиперхолестеринемии (применение Европейских рекомендаций 1994 г. к российским условиям). Кардиология 1996; 3: 49-53.
  47. Weiss T. E., Segaloff A. Gouty arthritis and gout. Springfield, Ill.: Thomas; 1959. 7.
  48. Rapado A. Relationship between gout and arterial hypertension. Adv. Exp. Med. Biol. 1974; 41: 451-459.
  49. Wyngaarden J. B., Kelly W. N. Gout and hyperuricemia. New York; 1976. 32-33.
  50. Kuzell W. C., Schaffarzick R. W., Naugler W. E. et al. Some observations on 520 gouty patients. J. Chron. Dis. 1995; 2 (6): 645-669.
  51. Raison J., Safar M., Asmar R. E. et al. Sex dependent of body fat distribution and fluid volumes in hypertension. Kidney Int. 1988; 25: 122-124.
  52. Ford E. S., Cooper R. S. Risk factors for hypertension a national cohort study. Hypertension 1991; 18: 598-606.
  53. Vazguez-Mellado J., Garsia C. G., Vazguez S. G. et al. Metabolic syndrome and ischemic heart disease in gout. J. Clin. Rheumatol. 2004; 10 (3): 105-109.
  54. Ильиных Е. В. Факторы риска развития кардиоваскулярных заболеваний у больных подагрой: Автореф. дис. ... канд. мед. наук. М.; 2006.
  55. Yusuf S., Hawken S., Ounpuu S. et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937.
  56. Stamler J., Stamler R., Neaton J. D. et al. Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. J. A. M. A. 1999; 282: 2012.
  57. Vasan R. S., Sullivan L. M., Wilson P. W. et al. Relative importance of borderline and elevated levels of coronary heart disease risk factors. Ann. Intern. Med. 2005; 142: 393.
  58. Ridker P. M., Buring J. E., Cook N. R., Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events. An 8-year follow-up of 14719 initially healthy American women. Circulation 2003; 107: 391-397.
  59. Shishenbor M. H., Bhatt D. L., Topol E. J. Using C-reactive protein to asses cardiovascular disease risk. Cleveland Clin. J. Med. 2003; 70 (7): 634-640.
  60. Barinas-Mitchell E., Cushman M., Meilahn E. N. et al. Serum levels of C-reactive protein are associated with obesity, weight gain, and hormone replacement therapy in healthy postmenopausal women. Am. J. Epidemiol. 2001; 153 (11): 1094-1101.
  61. Rifai N., Buring J. E., I-Min Lee et al. Is C-reactive protein specific for vascular disease in women? Ann. Intern. Med. 2002; 136 (7): 529-533.
  62. Editorial. Koenig W., Pepys M. B. C-reactive protein risk prediction: low specificity, high sensitivity. Ann. Intern. Med. 2002; 136 (7): 550-552.
  63. Blake G. J., Rifai N., Buring J. E., Ridker P. M. Blood pressure, C-reactive protein, and risk of future cardiovascular events. Circulation 2003; 108: 2993-2999.
  64. Ridker P. M. CRP. A simple test to help predict risk of heart attack and stroke. Circulation 2003; 108: e81-e85.

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