Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya29836Editorial articleПередовая статьяImmunoresistance syndrome in gout patients and its influence on formation of clinical features of the diseaseСиндром инсулинорезистентности у больных подагрой и его влияние на формирование клинических особенностей болезниBarskovaV GБарсковаВ Г

ГУ Институт ревматологии РАМН

EliseevM SЕлисеевМ С

ГУ Институт ревматологии РАМН

NasonovE LНасоновЕ Л

ГУ Институт ревматологии РАМН

YakuninaI AЯкунинаИ А

ГУ Институт ревматологии РАМН

ZilovA VЗиловА В

ММА им. И. М. Сеченова

IlyinykhE VИльиныхЕ В

ГУ Институт ревматологии РАМН

ГУ Институт ревматологии РАМНММА им. И. М. Сеченова15052004795NO5 (2004)ТОМ 79, №5 (2004)515609042020Copyright ©; 2004, Consilium MedicumCopyright ©; 2004, ООО "Консилиум Медикум"2004Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/29836

Aim. To evaluate the occurrence of immunoresistance (IR) syndrome in gout and its correlation with a gout course. Material and methods. Anthropometric parameters, blood lipid spectrum, levels of glucose, uric acid (UA), immunoreactive insulin, HOMA index were studied in 55 male patients with gout (mean age 50.1 ± 7.9 years, mean duration of the disease 7.5 ± 7.2 years). Statistic processing was made with computer program Statistica 6.0. Results. IR was revealed in 49% patients. Immunoresistant patients had visceral obesity, arterial hypertension, abnormal lipid profde, high UA concentrations, longer disease, chronic articular syndrome, high occurrence of diabetes mellitus and vascular events significantly more frequently. Conclusion. IR in gout patients is the risk factor of cardiovascular diseases; combination of IR and hyperinsulinemia is characterized by marked hyperuricemia and a trend to chronic course of the articular syndrome. Longer duration of gout, especially treated inadequately, raises the risk of IR. IR deteriorates prognosis in relation to cardiovascular diseases, diabetes mellitus type 2, course of gout itself.

Цель исследования. Изучение частоты выявления синдрома инсулинорезистентности (ИР) при подагре и его связи с особенностями течения заболевания. Материалы и методы. Наблюдали 55 мужчин с диагнозом подагры (средний возраст 50,1 ± 7,9 года, средняя продолжительность заболевания 7,5 ± 7,2 года). Оценивали антропометрические параметры, показатели липидного спектра крови, уровень глюкозы, мочевой кислоты (МК), иммунореактивного инсулина, индекс НОМА (Homeostasis model assessment). Статистическая обработка проводилась при помощи компьютерной программы Statistica 6.O. Результаты. ИР, оцененная с помощью индекса НОМА, выявлена у 49% больных, у них достоверно чаще выявляют висцеральное ожирение, артериальную гипертонию, изменения липидного профиля, повышение уровня МК, увеличение продолжительности заболевания, хронический суставной синдром, повышение частоты развития сахарного диабета и сосудистых катастроф. Заключение. Наличие ИР у больных подагрой является не только фактором риска возникновения сердечно-сосудистых заболеваний; сочетание гиперинсулинемии и ИР характеризуется значительной гиперурикемией и тенденцией к хроническому течению суставного синдрома. Полученные данные также свидетельствуют, что увеличение длительности болезни, особенно при отсутствии адекватной терапии, повышает риск возникновения ИР. Можно предположить, что при ИР прогноз заболевания менее благоприятен в отношении развития сердечнососудистых расстройств, сахарного диабета типа 2 и течения собственно подагры.

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