Carbohydrate metabolic disturbances in gout: detection rate and clinical featureS


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Aim. To study the clinical features of gout concurrent with carbohydrate metabolic disturbances.
Subjects and methods. One hundred and ninety-five patients with gout were examined. Their mean age was 54.8 ± 10.4 years; disease duration was 10 (6-15) years. Anthropometry was estimated; the levels of uric acid (UA), creatinine, and lipid metabolic parameters were measured fasting; the concentrations of glucose were estimated fasting and 2 hours after use of 75 g of glucose; UA excretion and glomerular filtration rate were calculated.
Results. Carbohydrate metabolic disorders were found in 112 (57.4%) patients with gout: type 2 diabetes (T2D) in 67 (34.3%); impaired fasting glycemia in 23 (11.8%); impaired glucose tolerance in 22 (11.3%); the diagnosis of T2D was first detected in 35 patients with gout, in 12 of the 35 (34%) cases after oral glucose tolerance test (OGTT). The detection rate of carbohydrate metabolic disturbances was in direct proportion to serum UA levels. This value was 513.7 ± 122.2 μmol/l in gouty patients with carbohydrate metabolic disturbances and 472.4 ± 121.9 μmol/l in normoglycemic patients (p = 0.026). High body mass index and elevated serum were significantly determined in hyperglycemic patients; coronary heart disease (CHD) and arterial hypertension were more frequently diagnosed.
Conclusion. OGTT causes a 34% increase in the detection rate of T2D in patients with gout. Carbohydrate metabolic disturbances are revealed in the majority of patients with gout and associated with obesity, hypertriglyceridemia, high serum UA levels, chronic disease forms, the high incidence of CHD and arterial hypertension.

About the authors

Maksim Sergeevich Eliseev

Email: elecmax@rambler.ru

Viktoriya Georgievna Barskova

Email: barskova@irramn.ru

M S Eliseev

Laboratory of Microcrystalline Arthritides, Research Institute of Rheumatology, Russian Academy of Medical Sciences

Laboratory of Microcrystalline Arthritides, Research Institute of Rheumatology, Russian Academy of Medical Sciences

V G Barskova

Laboratory of Microcrystalline Arthritides, Research Institute of Rheumatology, Russian Academy of Medical Sciences

Laboratory of Microcrystalline Arthritides, Research Institute of Rheumatology, Russian Academy of Medical Sciences

References

  1. Насонова В. А., Барскова В. Г. Ранние диагностика и лечение подагры - научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч.-практ. ревматол. 2004; 1: 5-7.
  2. 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.
  3. Rho Y. H., Choi S. J., Lee Y. H. et al. The prevalence of metabolic syndrome in patients with gout: A multicenter study. J. Korean Med. Sci. 2005; 20: 1029-1033.
  4. Барскова В. Г., Елисеев М. С., Насонов Е. Л. и др. Синдром инсулинорезистентности у больных подагрой и его влияние на формирование клинических особенностей болезни. Тер. арх. 2004; 5: 51-56.
  5. Grundy S. M., Cleeman J. I., Daniels S. R. et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005; 112 (17): 2735-2752.
  6. Wilson P. W., D'Agostino R. B., Parise H. et al. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005; 112 (20): 3066-3072.
  7. Ford E. S. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabet. Care 2005; 28 (7): 1769- 1778.
  8. Krishnan E., Baker J. F., Daniel E. F., Schumacher H. R. Gout and the risk of acute myocardial infarction. Arthr. and Rneum. 2006; 54 (8): 2688-2696.
  9. Kim S. Y., De Vera M. A., Choi H. K. Gout and mortality. Clin. Exp. Rheumatol. 2008; 26 (5, suppl. 51): S115-S119.
  10. Dehghan A., Van Hoek M., Sijbrands E. J. et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabet. Care 2008; 31: 361-362.
  11. Arromdee E., Michet C. J., Crowson C. S. et al. Epidemiology of gout: Is the incidence rising? J. Rheumatol. 2002; 29: 2403-2406.
  12. Nan H., Qiao Q., Soderberg S. et al. Serum uric acid and incident diabetes in Mauritian Indian and Creole populations. Diabet. Res. Clin. Pract. 2008; 80 (2): 321-327.
  13. Vuorinen-Markkola H., Yki-Jarvinen H. Hyperuricemia and insulin resistance. J. Clin. Endocrinol. 1994; 78 (1): 25-29.
  14. Bedir A., Topbas M., Tanyeri F. et al. Leptin might be a regulator of serum uric acid concentrations in humans. Jpn. Heart J. 2003; 44 (4): 527-536.
  15. Zimmet P. The burden of type 2 diabetes: are we doing enough? Diabet. Metab. 2003; 29 (4, pt 2): 6S9-6S18.
  16. Huang E. S., Basu A., O'Grady M., Capretta J. C. Projecting the future diabetes population size and related costs for the U. S. Diabet. Care 2009; 32 (12): 2225-2229.
  17. 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.
  18. Zhang W., Doherty M., Pascual-Gomez E. et al. EULAR evidence based recommendation for the diagnosis and management of gout. Ann. Rheum. Dis. 2005; 64 (suppl. III): 501.
  19. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation. 2006.
  20. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Clin. Chem. 1972; 18: 499-502.
  21. Annemans L., Spaepen E., Gaskin M. et al. Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000-2005. Ann. Rheum. Dis. 2008; 67: 960-966.
  22. Дедов И. И., Шестакова М. В. Сахарный диабет: Пособие для врачей. М.: Универсум Паблишинг; 2003.
  23. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabet. Care 1997; 20: 1183-1197.
  24. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies. Diabetologia 1999; 42: 647-654.
  25. Shaw J. E., de Courten M., Boyko E. J. et al. Impact of new diagnostic criteria for diabetes on different populations. Diabet. Care 1999; 22: 762-766.
  26. Saaristo T. E., Barengo N. C., Korpi-Hyovalti E. et al. High prevalence of obesity, central obesity and abnormal glucose tolerance in the middle-aged Finnish population. BMC Publ. Hlth 2008; 8: 423.
  27. Hofso D., Jenssen T., Hager H. et al. Fasting "Plasma Glucose in the screening for type 2 diabetes in morbidly obese subjects. Obes. Surg. 2009 Dec 1. [Epub ahead of print].
  28. Niskanen L., Laaksonen D. E., Lindstrom J. et al. Serum uric acid as a Harbinger of metabolic outcome in subjects with impaired glucose tolerance: The Finnish Diabetes Prevention Study. Diabet. Care 2006; 29 (3): 709-711.
  29. Choi H. K., De Vera M. A., Krishnan E. Gout and the risk of type 2 diabetes among men with a high cardiovascular risk profile. Rheumatology (Oxford) 2008; 47 (10): 1567-1570.
  30. Poje M., Rocic B. Diabetogenic action of alloxan-like derivatives of uric acid. Experientia 1980; 36: 78-79.
  31. Dominis M., Rocic S., Ashcroft S. J. H. et al. Diabetogenic action of alloxan-like compounds: cytoxic effects of 5-hydroxy-pseudouric acid and dehydrouramil hydratehydrochloride on rat pancreatic β-cells. Diabetologia 1984; 27: 403-406.
  32. Butler R., Morris A. D., Belch J. J. et al. Allopurinol normalizes endothelial dysfunction in type 2 diabetics with mild hypertension. Hypertension 2000; 35: 746-751.
  33. Maedler K., Sergeev P., Ris F. et al. Glucose-induced beta cell production of IL-1beta contributes to glucotoxicity in human pancreatic islets. J. Clin. Invest. 2002; 110: 851-860.
  34. Nakagawa T., Hu H., Zharikov S. et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am. J. Physiol. Renal Physiol. 2006; 290: F625-F631.
  35. Augustin R., Carayannopoulos M. O., Dowd L. O. et al. Identification and characterization of human glucose transporter-like protein-9 (GLUT9): alternative splicing alters trafficking. J. Biol. Chem. 2004; 279: 16229-16236.
  36. Brandstatter A., Kiechl S., Kollerits B. et al. Sex-specific association of the putative fructose transporter SLC2A9 variants with uric acid levels is modified by BMI. Diabet. Care 2008; 31: 1662-1667.
  37. Cheng X., Zhang H. Serum retinal-binding protein 4 is positively related to insulin resistance in Chinese subjects with type 2 diabetes. Diabet. Res. Clin. Pract. 2009; 84 (1): 58-60.
  38. Chang Y. H., Lin K. D., Wang C. L. et al. Elevated serum retinol-binding protein 4 concentrations are associated with renal dysfunction and uric acid in type 2 diabetic patients. Diabet. Metab. Res. Rev. 2008; 24 (8): 629-634.
  39. Chen C. C., Wu J. Y., Chang C. T. et al. Levels of retinol-binding protein 4 and uric acid in patients with type 2 diabetes mellitus. Metabolism 2009; 58 (12): 1812-1816.
  40. Елисеев М. С., Барскова В. Г., Насонов Е. Л. и др. Особенности подагры, протекающей с сахарным диабетом 2-го типа. Клин. геронтол. 2005; 4 (11): 7-13.
  41. Lee S. J., Hirsch J. D., Terkeltaub R. et al. Perceptions of disease and health-related quality of life among patients with gout. Rheumatology 2009; 48: 582-586.

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