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Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries. J Clin Med 2022; 11:jcm11133749. [PMID: 35807031 PMCID: PMC9267449 DOI: 10.3390/jcm11133749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult patients who underwent thoracolumbar spine surgery between January 2009 and June 2021, and 128 patients who had a history of gouty arthritis were included. Baseline characteristics and operative details were compared between the flare-up and no-flare groups. Multivariate logistic regression was used to analyze predictors and construct a predictive model of postoperative flares. This model was validated using a receiver operating characteristic (ROC) curve analysis. Fifty-six patients (43.8%) had postsurgical gout flares. Multivariate analysis identified gout medication use (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.14−0.75; p = 0.009), smoking (OR, 3.23; 95% CI, 1.34−7.80; p = 0.009), preoperative hemoglobin level (OR, 0.68; 95% CI, 0.53−0.87; p = 0.002), and hemoglobin drop (OR, 1.93; 95% CI, 1.25−2.96; p = 0.003) as predictors for postsurgical flare. The area under the ROC curve was 0.801 (95% CI, 0.717−0.877; p < 0.001). The optimal cut-off point of probability greater than 0.453 predicted gout flare with a sensitivity of 76.8% and specificity of 73.2%. The prediction model may help identify patients at an increased risk of gout flare.
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Zhu B, Li Y, Shi Y, Song N, Fang Y, Ding X. Long-term drinking behavior change patterns and its association with hyperuricemia in chinese adults: evidence from China Health and Nutrition Survey. BMC Public Health 2022; 22:1230. [PMID: 35725435 PMCID: PMC9210654 DOI: 10.1186/s12889-022-13637-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background We aimed to explore the association between long-term drinking behavior change patterns with hyperuricemia (HUA) in Chinese community adults. Methods This study was designed as a community-based unbalanced cohort study involving 4127 adults aged between 18 ~ 75 years, derived from the China Health and Nutrition Survey (CHNS) in 1997 and 2009. Drinking behavior change patterns were categorized into: never drinking, change to drinking, quitting drinking, and continued drinking. The alcoholism, type, and frequency of drinking were further categorized. We applied logistic regression models to explore the associations between drinking behavior change patterns and HUA. Results The average age of the participants was 54.6 (± 11.3) years and 47.8% were male. The overall prevalence of HUA was 15.5%. Drinking behavior change patterns of quitting (aOR 1.8; 95% CI 1.1 ~ 2.8) and continued drinking (aOR 2.0; 95% CI 1.3 ~ 3.0) were positively associated with high risks of HUA in the male participants. Early drinking behaviors such as liquor intake (aOR 1.8; 95% CI 1.4 ~ 2.5) and high consumption or frequency showed a positive correlation with HUA. Of note, heavy alcoholism (aOR 2.0; 95% CI 1.4 ~ 2.8) and daily drinking (aOR 2.5; 95% CI 1.7 ~ 3.6) had the highest risks of HUA. Furthermore, in the male participants, the association between early total alcohol intake and HUA was more pronounced at 18 standard drinks intake, with a stable increasing trend. In contrast, no statistical correlation was observed between the drinking behaviors and HUA in the female participants. Conclusions Drinking behavior change patterns of quitting and continued drinking are strongly associated with increased risks of HUA in males. The risks emanated from early drinking behaviors such as liquor drinking, high drinking frequency, and alcohol consumption. Although quitting drinking was associated with lower HUA risks compared to continued drinking, it still presented an undeniable risk for HUA. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13637-4.
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Affiliation(s)
- Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yiqin Shi
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Nana Song
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China. .,Shanghai Medical Center of Kidney, Shanghai, China. .,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.
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Zhang Y, Yang R, Dove A, Li X, Yang H, Li S, Wang J, Li WD, Zhao H, Xu W, Wang Y. Healthy lifestyle counteracts the risk effect of genetic factors on incident gout: a large population-based longitudinal study. BMC Med 2022; 20:138. [PMID: 35484537 PMCID: PMC9052486 DOI: 10.1186/s12916-022-02341-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Risk genes linked to the development of gout have been identified, and lifestyle factors are related to gout risk. It remains unclear whether healthy lifestyle factors can mitigate the genetic risk of gout. Therefore, we aimed to explore whether and to what extent a healthy lifestyle can mitigate the risk of gout related to genetic factors. METHODS Within the UK Biobank, 416,481 gout-free participants (aged 37-74) were identified at baseline. Polygenic risk for gout was assessed and categorized as low (lowest tertile), middle (tertile 2), and high (highest tertile). Healthy lifestyle factors included no/moderate alcohol consumption, no smoking, physical activity, and a healthy diet. Participants were categorized into three groups according to their number of healthy lifestyle factors: unfavorable (0 or 1), intermediate (any 2), and favorable (3 or 4). Data were analyzed using Cox proportional hazard models. RESULTS Over the follow-up (median: 12.1 years), 6206 participants developed gout. Compared to low genetic risk, the hazard ratios (HRs) and 95% confidence intervals (CIs) of gout was 1.44 (1.35-1.54) for middle and 1.77 (1.66-1.89) for high genetic risk. The HRs (95% CIs) of gout were 0.63 (0.59-0.67) for a favorable lifestyle and 0.79 (0.75-0.85) for an intermediate lifestyle, compared to an unfavorable lifestyle. In joint effect analysis, compared to participants with low genetic predisposition and a favorable lifestyle, the HRs (95% CIs) of gout were 2.39 (2.12-2.70)/3.12 (2.79-3.52) in those with middle and high genetic predisposition plus unfavorable lifestyle profiles, and 1.53 (1.35-1.74)/1.98 (1.75-2.24) for those with middle and high genetic predisposition plus favorable lifestyle profiles, respectively. Moreover, compared to an unfavorable lifestyle, the HRs of gout related to a favorable lifestyle was 0.64 (95% CI, 0.56-0.73) for low genetic risk, 0.65 (95% CI, 0.58-0.72) for middle genetic risk, and 0.62 (95% CI, 0.57-0.69) for high genetic risk. There was a significant additive interaction between unfavorable lifestyle and high genetic risk on gout. CONCLUSIONS Healthy lifestyle was associated with a lower risk of gout and may attenuate the risk of gout related to genetic factors by almost a third.
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Affiliation(s)
- Yuan Zhang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, 300070, Tianjin, China
| | - Rongrong Yang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, 300070, Tianjin, China.,Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Xuerui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongxi Yang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, 300070, Tianjin, China
| | - Shu Li
- School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ju Wang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China
| | - Wei-Dong Li
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, USA
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Health Care Sciences and Society Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, 300070, Tianjin, China. .,Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Abstract
Gout is the most common inflammatory arthritis in the United States. Gouty arthritis is associated with significant morbidity and mortality and is the result of chronic hyperuricemia. Gout is effectively managed and potentially cured by decreasing the overall urate burden with serum urate-lowering therapy. When serum urate is maintained at less than 6.0 mg/dL, urate deposition is resolved, and gout can be cured. Unfortunately, because of less than optimal physician monitoring and dose escalation, many patients do not achieve these urate levels.
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Affiliation(s)
- Sarah F Keller
- Department of Rheumatic & Immunologic Diseases, The Cleveland Clinic, 9500 Euclid Avenue A50, Cleveland, OH 44915, USA.
| | - Brian F Mandell
- Department of Rheumatic & Immunologic Diseases, The Cleveland Clinic, 9500 Euclid Avenue A50, Cleveland, OH 44915, USA
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55
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Banerjee P, Saha I, Sarkar D, Maiti AK. Contributions and Limitations of Mitochondria-Targeted and Non-Targeted Antioxidants in the Treatment of Parkinsonism: an Updated Review. Neurotox Res 2022; 40:847-873. [PMID: 35386026 DOI: 10.1007/s12640-022-00501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
Abstract
As conventional therapeutics can only treat the symptoms of Parkinson's disease (PD), major focus of research in recent times is to slow down or prevent the progression of neuronal degeneration in PD. Non-targeted antioxidants have been an integral part of the conventional therapeutics regimen; however, their importance have lessened over time because of their controversial outcomes in clinical PD trials. Inability to permeate and localize within the mitochondria remains the main drawback on the part of non-targeted antioxidants inspite of possessing free radical scavenging properties. In contrast, mitochondrial-targeted antioxidants (MTAs), a special class of compounds have emerged having high advantages over non-targeted antioxidants by virtue of efficient pharmacokinetics and better absorption rate with capability to localize many fold inside the mitochondrial matrix. Preclinical experimentations indicate that MTAs have the potential to act as better alternatives compared to conventional non-targeted antioxidants in treating PD; however, sufficient clinical trials have not been conducted to investigate the efficacies of MTAs in treating PD. Controversial clinical outcomes on the part of non-targeted antioxidants and lack of clinical trials involving MTAs have made it difficult to go ahead with a direct comparison and in turn have slowed down the progress of development of safer and better alternate strategies in treating PD. This review provides an insight on the roles MTAs and non-targeted antioxidants have played in the treatment of PD till date in preclinical and clinical settings and discusses about the limitations of mitochondria-targeted and non-targeted antioxidants that can be resolved for developing effective strategies in treating Parkinsonism.
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Affiliation(s)
- Priyajit Banerjee
- Department of Zoology, University of Burdwan, Burdwan, West Bengal, Pin-713104, India
| | - Ishita Saha
- Department of Physiology, Medical College Kolkata, Kolkata, West Bengal, Pin-700073, India
| | - Diptendu Sarkar
- Department of Microbiology, Ramakrishna Mission Vidyamandira, Belur Math, Howrah, West Bengal, 711202, India
| | - Arpan Kumar Maiti
- Mitochondrial Biology and Experimental Therapeutics Laboratory, Department of Zoology, University of North Bengal, District - Darjeeling, P.O. N.B.U, Raja Rammohunpur, West Bengal, Pin-734013, India.
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56
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The Relationship between Alcohol Consumption and Gout: A Mendelian Randomization Study. Genes (Basel) 2022; 13:genes13040557. [PMID: 35456363 PMCID: PMC9028689 DOI: 10.3390/genes13040557] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/12/2022] [Accepted: 03/16/2022] [Indexed: 01/27/2023] Open
Abstract
Gout is a disease that manifests itself after decades of following a high-purine diet, with excessive alcohol consumption assumed to be one of the main contributors to the development of the disease. This study performs a Mendelian randomization (MR) analysis to determine whether alcohol consumption causally affects the risk of developing both hyperuricemia and gout. The results indicate that genetically predicted drinks consumed per week have no causal effect on neither the risk of gout (p = 0.35), nor serum uric acid levels (p = 0.73). For MR analysis in the other direction, genetic risk of gout was significantly associated with drinks per week (p = 0.03). Furthermore, the results of the MR analysis were verified in a cohort of individuals diagnosed with hyperuricemia and gout, comprising of alcohol-consuming and alcohol-abstaining subgroups. When split by alcohol status, the serum uric acid levels failed to show a significant difference in both gout (p = 0.92) and hyperuricemia (p = 0.23) subgroups. Overall, the results suggest that increased alcohol consumption does not play a causal role in the development of gout.
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57
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Yokose C, McCormick N, Lu N, Joshi AD, Curhan G, Choi HK. Adherence to 2020 to 2025 Dietary Guidelines for Americans and the Risk of New-Onset Female Gout. JAMA Intern Med 2022; 182:254-264. [PMID: 35099520 PMCID: PMC8804972 DOI: 10.1001/jamainternmed.2021.7419] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/02/2021] [Indexed: 02/02/2023]
Abstract
IMPORTANCE Female-specific gout data are scarce despite perceived differences from males in its risk factors and disproportionate worsening in disease and comorbidity burden globally. The 2020 to 2025 Dietary Guidelines for Americans recommend multiple healthy eating patterns for prevention of cardiovascular-metabolic outcomes, which may also be relevant to the prevention of female gout. OBJECTIVE To examine the associations of dietary scores for the latest guideline-based healthy eating patterns with risk of incident female gout. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study included 80 039 US women in the Nurses' Health Study followed up through questionnaires every 2 years starting from 1984. Participants had no history of gout at baseline, and the study used questionnaire responses through 2018. Statistical analyses were performed over September 2020 to August 2021. EXPOSURES Four healthy eating patterns: Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet Score, Alternative Healthy Eating Index (AHEI), and Prudent, plus Western (unhealthy) for comparison, with scores derived from validated food frequency questionnaires. MAIN OUTCOMES AND MEASURES Incident, physician-diagnosed female-specific gout. RESULTS During 34 years of follow-up, we documented 3890 cases of incident female gout. Compared with the least-adherent quintile, women most adherent to healthy diets had significantly lower risk of incident gout, with multivariable-adjusted hazard ratios (HRs) 0.68 (95% CI, 0.61-0.76) (DASH), 0.88 (95% CI, 0.80-0.98) (Mediterranean), 0.79 (95% CI, 0.71-0.89) (AHEI), and 0.75 (95% CI, 0.73-0.90) (Prudent); all P for trend ≤.009. Conversely, women with highest-quintile Western diet score had 49% higher risk of gout (HR, 1.49; 95% CI, 1.33-1.68], P <.001). When combined, the most DASH-diet adherent women with normal body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) had a 68% lower risk of gout compared with the least adherent women with overweight or obese BMI; the corresponding risk reduction was 65% combining high DASH diet adherence with no diuretic use. CONCLUSIONS AND RELEVANCE These large-scale, long-term prospective cohort findings extend the pleotropic benefits of the 2020 to 2025 Dietary Guidelines for Americans to female gout prevention, with multiple healthy diets that can be adapted to individual food traditions, preferences, and comorbidities.
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Affiliation(s)
- Chio Yokose
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Natalie McCormick
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Na Lu
- Arthritis Research Canada, Richmond, British Columbia, Canada
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amit D. Joshi
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Gary Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston MA
| | - Hyon K. Choi
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston
- Arthritis Research Canada, Richmond, British Columbia, Canada
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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58
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Singh JA. Epidemiology and Outcomes of Alcohol Use Hospitalizations in People With Gout, Rheumatoid Arthritis, Fibromyalgia, Osteoarthritis, or Low Back Pain: A National US Study. J Clin Rheumatol 2022; 28:e375-e380. [PMID: 33843780 DOI: 10.1097/rhu.0000000000001731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the incidence, time trends, and outcomes of alcohol use disorder (AUD) hospitalizations in people with gout, rheumatoid arthritis (RA), fibromyalgia, osteoarthritis, or low back pain (LBP). METHODS We used the US National Inpatient Sample data from 1998 to 2016. We examined the rates of AUD hospitalizations in musculoskeletal diseases (MSDs), based on the presence of diagnostic codes for AUD in the primary and MSDs in a secondary position. Multivariable-adjusted (age, sex, race, and income) health care utilization and in-hospital mortality were compared by the presence/absence of MSDs, using linear or logistic regression. RESULTS Alcohol use disorder hospitalizations increased over the 19-year study period from 1998 to 2014 to 3-fold higher in gout, osteoarthritis, or LBP; 3.5-fold in RA; and 4.5-fold in fibromyalgia. Compared with AUD hospitalizations in people without each respective MSD, adjusted total hospital charges were $3913 higher in people with gout and $1368 to $1614 lower for osteoarthritis, fibromyalgia, or LBP over the study period (all significant) and not significantly different for RA. The adjusted odds of hospital stay of more than 3 days were significantly higher for all 5 MSDs, with odds ratio ranging 1.10 for LBP to 1.34 for gout. The adjusted odds of in-hospital mortality were significantly lower for all 5 MSDs, with odds ratio ranging from 0.21 for fibromyalgia to 0.50 for gout. CONCLUSIONS In a national US study, the rate of AUD hospitalizations increased in all 5 MSDs. Providers and patients with MSDs should be counseled regarding the risk and impact of alcohol use. Interventions to reduce AUD hospitalization-associated health care burden in MSD are needed.
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Affiliation(s)
- Jasvinder A Singh
- From the Medicine Service, Birmingham Veterans Affairs (VA) Medical Center; and Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Association and interaction between dietary patterns and gene polymorphisms in Liangshan residents with hyperuricemia. Sci Rep 2022; 12:1356. [PMID: 35079028 PMCID: PMC8789849 DOI: 10.1038/s41598-021-04568-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Hyperuricemia (HUA) is associated with dietary and genetic factors. However, studies on dietary patterns and their interaction effect with genes on the risk of HUA are limited. We aimed to explore the association between dietary patterns and HUA, and dietary patterns—gene interactions on the risk of HUA. A population-based cross-sectional study was conducted in adults aged 18 and older in Liangshan Yi Autonomous Prefecture of China. Dietary consumption was collected using a standard Food Frequency Questionnaire. Vein blood samples were collected after overnight fasting, and DNA was extracted from peripheral blood leukocytes. Dietary patterns were derived using principal component and factor analysis. Of the 2646 participants, the prevalence of HUA was 26.8%. Three dietary patterns were classified. Of them, a dietary pattern with higher meat consumption (defined as meat-based) had the strongest association with HUA than a dietary pattern with plant-based or local special diet-based. A higher frequency of T allele at ABCG2 rs2231142 and SLC2A9 rs11722228 loci was observed in participants with HUA than those without HUA. An additive interaction of meat-based dietary pattern with rs2231142 locus was significantly associated with an increased risk of HUA. The relative excess risks of interaction, attributable proportion of interaction, and synergy index (S) were 0.482 (95% CI: 0.012–0.976), 0.203 (95% CI: 0.033–0.374), and 1.544 (95% CI: 1.012–2.355), respectively. In conclusion, a dietary pattern with meat-based was significantly associated with an increased risk of HUA. There was an additive interaction between a meat-based dietary pattern and the ABCG2 rs2231142 locus. Individuals with rs2231142 T allele were at higher risk of HUA than those with rs2231142 GG allele.
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Abstract
The involvement of inflammasomes in the proinflammatory response observed in chronic liver diseases, such as alcohol-associated liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD), is widely recognized. Although there are different types of inflammasomes, most studies to date have given attention to NLRP3 (nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3) in the pathogenesis of ALD, NAFLD/nonalcoholic steatohepatitis, and fibrosis. Canonical inflammasomes are intracellular multiprotein complexes that are assembled after the sensing of danger signals and activate caspase-1, which matures interleukin (IL)-1β, IL-18, and IL-37 and also induces a form of cell death called pyroptosis. Noncanonical inflammasomes activate caspase-11 to induce pyroptosis. We discuss the different types of inflammasomes involved in liver diseases with a focus on (a) signals and mechanisms of inflammasome activation, (b) the role of different types of inflammasomes and their products in the pathogenesis of liver diseases, and (c) potential therapeutic strategies targeting components of the inflammasomes or cytokines produced upon inflammasome activation.
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Affiliation(s)
- Marcelle de Carvalho Ribeiro
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA; ,
| | - Gyongyi Szabo
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA; ,
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61
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Shvabskaia OB, Izmailova OV, Karamnova NS, Drapkina OM. Hyperuricemia: Features of the Diet. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2021-12-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The association of hyperuricemia (HU) with cardiovascular disease (CVD), diabetes, metabolic syndrome, and kidney disease has been demonstrated in numerous studies. НU is the main pathogenetic factor in the development of gout and is associated with an increase in overall and cardiovascular mortality. НU is included in the list of factors determining cardiovascular risk. According to epidemiological studies, there is a high prevalence of HU in the world and its increase in recent decades. A number of factors have been identified that contribute to the increased risk of НU. Non-modifiable factors include gender, age, genetic factors, and modifiable factors include diet and lifestyle. Nutritional unbalances, increased life expectancy, increased prevalence of obesity, and increased use of drugs (especially diuretics) are seen as contributing factors to the rise in НU. The review was carried out to summarize the available information on the effect of dietary habits, individual foods and nutrients on serum uric acid (SUA) levels and the risk of developing HU. The review presents the results of scientific studies demonstrating the relationship of НU with the consumption of foods rich in purines (offal, red meat, fish, seafood, legumes), alcohol consumption, drinks sweetened with fructose, coffee, dairy products, vegetables and fruits. Diet correction is an important and necessary step in the prevention and treatment of НU. The article reviews the basic principles of dietary management in HU and provides dietary recommendations for patients. For effective prevention and treatment of НU, a mandatory correction of the diet is required.
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Affiliation(s)
- O. B. Shvabskaia
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Luo Z, Yang F, Hong S, Wang J, Chen B, Li L, Yang J, Yao Y, Yang C, Hu Y, Wang S, Xu T, Wu J. Role of microRNA alternation in the pathogenesis of gouty arthritis. Front Endocrinol (Lausanne) 2022; 13:967769. [PMID: 36034424 PMCID: PMC9402903 DOI: 10.3389/fendo.2022.967769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/19/2022] [Indexed: 11/22/2022] Open
Abstract
Gouty arthritis is a common inflammatory disease. The condition is triggered by a disorder of uric acid metabolism, which causes urate deposition and gout flares. MicroRNAs are a class of conserved small non-coding RNAs that bind to the 3' untranslated region (UTR) of mRNA and regulate the expression of a variety of proteins at the post-transcriptional level. In recent years, attention has been focused on the role of miRNAs in various inflammatory diseases, including gouty arthritis. It is thought that miRNAs may regulate immune function and inflammatory responses, thereby influencing the onset and progression of the disease. This article mainly reviewed the roles of miRNAs in the pathogenesis of gouty arthritis and prospected their potential as diagnostic and prognostic relevant biomarkers and as possible therapeutic targets.
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Affiliation(s)
- Zhipan Luo
- The First Affifiliated Hospital, Anhui Medical University, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Fan Yang
- The First Affifiliated Hospital, Anhui Medical University, Hefei, China
| | - Shaocheng Hong
- The First Affifiliated Hospital, Anhui Medical University, Hefei, China
| | - Jianpeng Wang
- The First Affifiliated Hospital, Anhui Medical University, Hefei, China
| | - Bangjie Chen
- The First Affifiliated Hospital, Anhui Medical University, Hefei, China
| | - Liangyun Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Junfa Yang
- Institute of clinical pharmacology, Anhui Medical University, Hefei, China
| | - Yan Yao
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Chenchen Yang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Ying Hu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Shuxian Wang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Tao Xu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- Anhui Institute of Innovative Drugs, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
- *Correspondence: Tao Xu, ; Jun Wu,
| | - Jun Wu
- Geriatric Department, The First Affifiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Tao Xu, ; Jun Wu,
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Russell MJ, Kim S, Lenert A. A patient-centered gout information value chain: a scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:30-43. [PMID: 34120817 PMCID: PMC8651807 DOI: 10.1016/j.pec.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine and identify the scope of research addressing health information requirements for gout patients using value chain analysis. METHODS Five electronic databases (PubMed, CINAHL, ERIC, PsycINFO, Embase, and Scopus) and grey literature (WorldCat) were searched in accordance with a published protocol. Only English language articles were included, with no limitations for date of publication. The findings of the 33 studies included for final analysis were subsequently divided into 6 groups according to the stages of the care delivery value chain their research most closely pertained to: screening/preventing (n = 2), diagnosing (n = 1), preparing (n = 7), intervening (n = 11), recovering/rehabilitating (n = 5), and monitoring/managing (n = 13). RESULTS The 33 studies focused on one or more of the following information phenotypes: 1) pathophysiology; 2) medical treatment; and 3) nonpharmaceutical interventions. Long term treatment adherence was a popular topic amongst studies that focused on gout patient education. CONCLUSION Based on the identified studies, gout patients are being told what to do, but are not being adequately educated regarding why recommended interventions are important or how to accomplish them. PRACTICE IMPLICATIONS This review provides a foundation to develop and evaluate personalized education materials using value chain analysis.
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Affiliation(s)
- Maranda J Russell
- Department of Communication, College of Communication and Information & Division of Biomedical Informatics, College of Medicine, University of Kentucky, USA
| | - Sujin Kim
- Division of Biomedical Informatics, College of Medicine & School of Information Science, College of Communication and Information, University of Kentucky, USA.
| | - Aleksander Lenert
- Division of Immunology, Carver College of Medicine, University of Iowa, USA
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Weaver JS, Vina ER, Munk PL, Klauser AS, Elifritz JM, Taljanovic MS. Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging. J Clin Med 2021; 11:jcm11010166. [PMID: 35011907 PMCID: PMC8745871 DOI: 10.3390/jcm11010166] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/16/2021] [Accepted: 12/26/2021] [Indexed: 12/22/2022] Open
Abstract
Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.
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Affiliation(s)
- Jennifer S. Weaver
- Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA;
- Correspondence:
| | - Ernest R. Vina
- Department of Medicine, University of Arizona Arthritis Center, Tucson, AZ 85724, USA;
| | - Peter L. Munk
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
| | - Andrea S. Klauser
- Radiology Department, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Jamie M. Elifritz
- Departments of Radiology and Pathology, University of New Mexico, Albuquerque, NM 87131, USA;
- New Mexico Office of the Medical Investigator, Albuquerque, NM 87131, USA
| | - Mihra S. Taljanovic
- Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA;
- Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85721, USA
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65
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Singh JA. SToRytelliing to Improve Disease outcomes in Gout (STRIDE-GO) in African American veterans with gout: a trial study protocol. Trials 2021; 22:879. [PMID: 34863255 PMCID: PMC8645140 DOI: 10.1186/s13063-021-05847-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/20/2021] [Indexed: 11/28/2022] Open
Abstract
Objective Medication adherence in gout is suboptimal, and the lack of effective interventions to address it presents a huge challenge. Medication adherence and gout outcomes are worse in racial/ethnic minorities. The objective of this paper was to provide the details of the study protocol for randomized, controlled trial (RCT) in African Americans (AAs) with gout that will test the effectiveness of a culturally appropriate gout storytelling intervention. Methods The SToRytelliing to Improve Disease outcomes in Gout (STRIDE-GO) study will be a 12-month, multicenter, open-label RCT that will assess the effect of a culturally appropriate gout storytelling in at least 300 AA veterans with gout. Participants will be randomized to gout-storytelling intervention vs. a stress reduction video in a 1:1 ratio. The primary outcome is urate-lowering therapy (ULT) adherence measured with MEMSCap™, an electronic monitoring system (efficacy, 6 months; sustenance of efficacy, 12 months). Secondary outcomes include gout flares, serum urate (SU), gout-specific health-related quality of life [HRQOL], self-reported ULT adherence, patient satisfaction with treatment, and patient understanding of the intervention. AA veterans with gout who met the 1977 Preliminary American College of Rheumatology (ACR) classification criteria for gout, currently prescribed an oral ULT medication (allopurinol or febuxostat) for at least 6 months, and not using a pillbox to redistribute their medications, will be invited to an in-person study visit. After the study coordinators obtain informed consent, and ensure that participants meet the inclusion criteria, the eligible participants will be provided with their current ULT in a MEMSCap™ bottle for the 1-month run-in period and asked to return to the clinic in 1 month. ULT adherence with MEMSCap™ will be recorded at a 1-month return visit. Interested participants will complete the baseline assessments, randomized using the computerized system to either gout-storytelling intervention or a stress reduction intervention video arm and watch the respective video in-clinic. Patients will be interviewed on the phone at 2 and 4 months regarding the viewing of the videos at home at each time. Participants will be assessed in-clinic at 3, 6, 9, and 12 months; MEMSCap™ data and patient surveys will be captured at each visit. For any missed visit, assessments will be completed on the phone and MEMSCap™ data captured at the next in-clinic visit. Discussion The study will assess the efficacy of a behavioral intervention to improve ULT adherence in minority populations with gout. Trial registration ClinicalTrials.gov NCT 02741700. Registered on 14 September 2018 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05847-9.
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Affiliation(s)
- Jasvinder A Singh
- Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL, 35233, USA. .,Department of Medicine at School of Medicine, University of Alabama at Birmingham, 1720 Second Ave. South, Birmingham, AL, 35294-0022, USA. .,Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Ave. South, Birmingham, AL, 35294-0022, USA.
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66
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McCormick N, Yokose C, Lu N, Joshi AD, Curhan GC, Choi HK. Impact of adiposity on risk of female gout among those genetically predisposed: sex-specific prospective cohort study findings over >32 years. Ann Rheum Dis 2021; 81:556-563. [PMID: 34857519 DOI: 10.1136/annrheumdis-2021-221635] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/09/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To evaluate the joint (combined) association of excess adiposity and genetic predisposition with the risk of incident female gout, and compare to their male counterparts; and determine the proportion attributable to body mass index (BMI) only, genetic risk score (GRS) only, and to their interaction. METHODS We prospectively investigated potential gene-BMI interactions in 18 244 women from the Nurses' Health Study and compared with 10 888 men from the Health Professionals Follow-Up Study. GRS for hyperuricaemia was derived from 114 common urate-associated single nucleotide polymorphisms. RESULTS Multivariable relative risk (RR) for female gout was 1.49 (95% CI 1.42 to 1.56) per 5 kg/m2 increment of BMI and 1.43 (1.35 to 1.52) per SD increment in the GRS. For their joint association of BMI and GRS, RR was 2.18 (2.03 to 2.36), more than the sum of each individual factor, indicating significant interaction on an additive scale (p for interaction <0.001). The attributable proportions of joint effect for female gout were 42% (37% to 46%) to adiposity, 37% (32% to 42%) to genetic predisposition and 22% (16% to 28%) to their interaction. Additive interaction among men was smaller although still significant (p interaction 0.002, p for heterogeneity 0.04 between women and men), and attributable proportion of joint effect was 14% (6% to 22%). CONCLUSIONS While excess adiposity and genetic predisposition both are strongly associated with a higher risk of gout, the excess risk of both combined was higher than the sum of each, particularly among women.
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Affiliation(s)
- Natalie McCormick
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA .,Arthritis Research Canada, Vancouver, British Columbia, Canada.,Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Chio Yokose
- Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Rheumatology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Na Lu
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Amit D Joshi
- Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Clinical Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Renal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hyon K Choi
- Arthritis Research Canada, Vancouver, British Columbia, Canada .,Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Abstract
BACKGROUND Gout is the most common form of inflammatory arthritis, affecting 41 million adults worldwide. The global burden of gout has been increasing over the last three decades, yet its management remains suboptimal. The primary aim of this manuscript is to review the impact of various diets such as the DASH, Mediterranean, and low purine diets; weight loss; and individual foods, including alcohol, caffeine, cherry, dairy, high-fructose corn syrup, omega-3 fatty acids, and vitamin C on hyperuricemia and clinical gout outcomes such as flares and tophi. CONCLUSION Few studies to date have specifically evaluated the effect of various dietary approaches on hyperuricemia among people with gout and on gout-specific outcomes. Overall, the dietary factors appear to have a small effect on serum urate levels, and their impact on the long-term clinical course of gout is uncertain. Limited evidence suggests that avoidance of certain foods and beverages may decrease the frequency of gout flares. Weight loss may be beneficial for prevention as well as treatment of gout. Urate-lowering therapy remains the mainstay of therapy, with diet and dietary factors studied to date playing a limited role in the definitive management of gout.
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Affiliation(s)
| | - Shiv Tej Sehra
- Harvard Medical School, Boston, MA, USA; Mount Auburn Hospital, Cambridge, MA, USA
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, MA, USA.
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68
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Pang S, Jiang Q, Sun P, Li Y, Zhu Y, Liu J, Ye X, Chen T, Zhao F, Yang W. Hyperuricemia prevalence and its association with metabolic disorders: a multicenter retrospective real-world study in China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1550. [PMID: 34790756 PMCID: PMC8576711 DOI: 10.21037/atm-21-5052] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022]
Abstract
Background The prevalence of hyperuricemia (HUA) and gout continues to increase in China. Research suggests that HUA may be related to many diseases other than gout. However, further population research is required to investigate the association between HUA and metabolic syndromes. This study sought to investigate the prevalence of HUA in an average population in China, and the association between serum uric acid (UA) levels and related metabolic disorders. Methods This multicenter retrospective real-world study examined the hospital information system data of 4 tertiary hospitals in 3 provinces in China. The data of patients aged between 18 and 80 years, who had attended at least 1 medical appointment at which their UA level was recorded, were analyzed to evaluate associations between UA levels and metabolic disorders. Results Among the 374,506 enrolled subjects (49.7% male; mean age 51.5 years old), the overall prevalence of HUA and gout were 14.8% and 0.5%, respectively. The prevalence was higher among males than females (17.6% vs. 12.0%, 0.8% vs. 0.1%; both P<0.001). Groups exhibiting higher UA levels had increased adjusted odds ratios for dyslipidemia and chronic kidney disease (CKD) in both sexes. Changes in UA levels from the baseline were negatively correlated with changes in the estimated glomerular filtration rate and hemoglobin A1c among both sexes (all P<0.001), and were positively correlated with changes in total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) (all P<0.05) among males, and changes in TC, TG, LDL-C and glucose (all P<0.001) among females. Conclusions HUA is associated with dyslipidemia and CKD both cross-sectionally and longitudinally. Similar phenomena were observed in both sexes.
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Affiliation(s)
- Shuguang Pang
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qiang Jiang
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Pei Sun
- Department of Endocrinology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yi Li
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Yanhua Zhu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Jin Liu
- Jiangsu Hengrui Pharmaceuticals Co., Ltd., Lianyungang, China
| | - Xiaoran Ye
- Shanghai Palan DataRx Co., Ltd., Shanghai, China
| | - Ting Chen
- Shanghai Palan DataRx Co., Ltd., Shanghai, China
| | - Fei Zhao
- Shandong Health Medical Big Data Co., Ltd., Jinan, China
| | - Wenjun Yang
- Department of Endocrinology, The Affiliated Hospital of Shandong University of TCM, Jinan, China
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Interaction of Alcohol Consumption and ABCG2 rs2231142 Variant Contributes to Hyperuricemia in a Taiwanese Population. J Pers Med 2021; 11:jpm11111158. [PMID: 34834509 PMCID: PMC8618280 DOI: 10.3390/jpm11111158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background: ABCG2 rs2231142 is an important genetic factor that contributes to the development of gout and hyperuricemia (HUA). Epidemiologic studies have demonstrated that lifestyle risk factors of HUA (e.g., alcohol consumption) and genetic predisposition (e.g., ABCG2 gene) together, contribute to enhanced serum uric acid levels. However, the interaction between ABCG2 rs2231142, alcohol consumption, and HUA in the Taiwanese population is still unclear. Therefore, this study investigated whether the risk of HUA is associated with ABCG2 rs2231142 variants and how this is affected by alcohol consumption. Method: study subjects were selected from the participants of the Taiwan Biobank database. Overall, 114,540 participants aged 30 to 70 years were enrolled in this study. The interaction between ABCG2 rs2231142, alcohol consumption, and serum uric acid (sUA) levels was analyzed by multiple logistic regression models. Results: the prevalence of HUA was 32.7% and 4.4 % in the male and female populations, respectively. In the whole study population, the minor T allele of ABCG2 rs2231142 was significantly associated with HUA risk, and the occurrence of HUA was high in TT genotype and TG genotype. The risk of HUA was significantly increased by the combined association of ABCG2 rs2231142 and alcohol consumption for TG/TT genotype compared to the GG genotype (wild-type genotype), especially among women. Conclusion: the ABCG2 rs2231142 is a crucial genetic locus for sUA levels in the Taiwanese population and our findings revealed that alcohol consumption combined with the ABCG2 rs2231142 risk allele contributes to increased HUA risk.
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Wakabayashi I, Daimon T. Associations of Blood Urate Level with Glycemic Status and Other Cardiometabolic Risk Factors in Middle-Aged Women. WOMEN'S HEALTH REPORTS 2021; 2:413-421. [PMID: 34671762 PMCID: PMC8524732 DOI: 10.1089/whr.2021.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/15/2022]
Abstract
Background: Hyperuricemia is a risk factor of cardiovascular disease. It remains to be elucidated how blood urate level is associated with hyperglycemia in women. Methods: The participants were 4612 middle-aged Japanese female workers. They were divided into four quartile groups by serum urate level, and cardiovascular risk factors were compared in the quartile groups. Results: With an increase of the quartile for urate, the means of waist-to-height ratio, systolic and diastolic blood pressure, log-transformed triglycerides, low-density lipoprotein (LDL) cholesterol, and cardiometabolic index (CMI) tended to be higher and high-density lipoprotein (HDL) cholesterol tended to be lower. Hemoglobin A1c was significantly higher in the 4th quartile for urate than in the 1st quartile, but this difference was not found when body mass index (BMI) was adjusted. The odds ratios versus the 1st quartile for high waist-to-height ratio, hypertension, hypertriglyceridemia, hypo-HDL cholesterolemia, hyper-LDL cholesterolemia, high CMI, and diabetes tended to be higher with an increase of the quartile. The odds ratios of the 4th versus 1st quartiles for these abnormalities except for high waist-to-height ratio and diabetes were significantly higher than the reference level even with adjustment for BMI. Hemoglobin A1c showed a weak but significant positive correlation with urate in analysis with adjustment for BMI. Conclusion: Blood urate was positively associated with adiposity, blood pressure, triglycerides, LDL cholesterol, and glycemic status and was inversely associated with HDL cholesterol in middle-aged women. The associations of urate with blood pressure, blood lipids, and glycemic status remained independent of adiposity, although being confounded by adiposity.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine and Hyogo College of Medicine, Nishinomiya, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Nishinomiya, Japan
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71
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Bardin T, Magnat E, Clerson P, Richette P, Rouchon B. Epidemiology of gout and hyperuricemia in New Caledonia. Joint Bone Spine 2021; 89:105286. [PMID: 34601114 DOI: 10.1016/j.jbspin.2021.105286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES New Caledonia is a Pacific island of 270,000 inhabitants with mixed ethnicities, including Polynesians (10.2%), people from European ancestry (27.2%), and Melanesians (39.1%),. This study aimed at determining the prevalence of gout and hyperuricemia in the general population and the various ethnicities of New Caledonia. METHODS A 3-degree random sample of the population aged 18 to 60 years was adjusted according to the 2014 New Caledonia census. Face-to-face planned interviews and physical measurements were performed by trained nurses. All consenting participants underwent capillary measurement of creatinine; all consenting men and only women older than 40 years underwent point-of-care uricemia testing. Gout was defined by a validated algorithm. Two definitions of hyperuricemia were used: capillary level equivalent to plasma uric acid level>360μmol/l (6mg/dl) and>420μmol/l (7mg/dl) and/or urate-lowering drug treatment for both thresholds. RESULTS We included 1144 participants (adjusted mean age 37.7±12.0 years; adjusted sex ratio 50.4% men). The adjusted prevalence of gout was 3.3% (95% confidence interval 2.2-4.9). Prevalence was 6.7% (2.5-16.8), 4.1% (1.8-8.9), and 2.6% (1.4-4.7) for Polynesians, Europeans and Melanesians, respectively, and 1.9% (0.5-6.6) for other ethnicities. Prevalence of hyperuricemia, determined in 658 participants, was 67.0% (61.9-71.6) and 37.0% (32.3-42.0) for the 360- and 420-μmol/l thresholds, respectively, and was significantly greater for Polynesians and Melanesians than Europeans for both thresholds. CONCLUSIONS The prevalence of gout and hyperuricemia in New Caledonia was high, including in patients of European descent.
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Affiliation(s)
- Thomas Bardin
- Department of Rheumatology, Lariboisière hospital APHP Paris Nord, and Université de Paris, INSERM U1132, Paris, France.
| | | | | | - Pascal Richette
- Department of Rheumatology, Lariboisière hospital APHP Paris Nord, and Université de Paris, INSERM U1132, Paris, France
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Scholz J, Roiser N, Braig EM, Petrich C, Birnbacher L, Andrejewski J, Kimm MA, Sauter A, Busse M, Korbel R, Herzen J, Pfeiffer D. X-ray dark-field radiography for in situ gout diagnosis by means of an ex vivo animal study. Sci Rep 2021; 11:19021. [PMID: 34561476 PMCID: PMC8463704 DOI: 10.1038/s41598-021-98151-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/01/2021] [Indexed: 12/27/2022] Open
Abstract
Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate (MSU) crystals in peripheral joints and tissue. Detection of MSU crystals is essential for definitive diagnosis, however the gold standard is an invasive process which is rarely utilized. In fact, most patients are diagnosed or even misdiagnosed based on manifested clinical signs, as indicated by the unchanged premature mortality among gout patients over the past decade, although effective treatment is now available. An alternative, non-invasive approach for the detection of MSU crystals is X-ray dark-field radiography. In our work, we demonstrate that dark-field X-ray radiography can detect naturally developed gout in animals with high diagnostic sensitivity and specificity based on the in situ measurement of MSU crystals. With the results of this study as a potential basis for further research, we believe that X-ray dark-field radiography has the potential to substantially improve gout diagnostics.
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Affiliation(s)
- Josef Scholz
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany.
| | - Nathalie Roiser
- Clinic for Birds, Small Mammals, Reptiles and Omamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, 85764, Oberschleißheim, Germany
| | - Eva-Maria Braig
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Christian Petrich
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Lorenz Birnbacher
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Jana Andrejewski
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Melanie A Kimm
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
- Department of Radiology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Madleen Busse
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Rüdiger Korbel
- Clinic for Birds, Small Mammals, Reptiles and Omamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, 85764, Oberschleißheim, Germany
| | - Julia Herzen
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
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Quantile-Dependent Expressivity of Serum Uric Acid Concentrations. Int J Genomics 2021; 2021:3889278. [PMID: 34545327 PMCID: PMC8448993 DOI: 10.1155/2021/3889278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 11/29/2022] Open
Abstract
Objective “Quantile-dependent expressivity” occurs when the effect size of a genetic variant depends upon whether the phenotype (e.g., serum uric acid) is high or low relative to its distribution. Analyses were performed to test whether serum uric acid heritability is quantile-specific and whether this could explain some reported gene-environment interactions. Methods Serum uric acid concentrations were analyzed from 2151 sibships and 12,068 offspring-parent pairs from the Framingham Heart Study. Quantile-specific heritability from offspring-parent regression slopes (βOP, h2 = 2βOP/(1 + rspouse)) and full-sib regression slopes (βFS, h2 = {(1 + 8rspouseβFS)0.5 − 1}/(2rspouse)) was robustly estimated by quantile regression with nonparametric significance assigned from 1000 bootstrap samples. Results Quantile-specific h2 (±SE) increased with increasing percentiles of the offspring's sex- and age-adjusted uric acid distribution when estimated from βOP (Ptrend = 0.001): 0.34 ± 0.03 at the 10th, 0.36 ± 0.03 at the 25th, 0.41 ± 0.03 at the 50th, 0.46 ± 0.04 at the 75th, and 0.49 ± 0.05 at the 90th percentile and when estimated from βFS (Ptrend = 0.006). This is consistent with the larger genetic effect size of (1) the SLC2A9 rs11722228 polymorphism in gout patients vs. controls, (2) the ABCG2 rs2231142 polymorphism in men vs. women, (3) the SLC2A9 rs13113918 polymorphism in obese patients prior to bariatric surgery vs. two-year postsurgery following 29 kg weight loss, (4) the ABCG2 rs6855911 polymorphism in obese vs. nonobese women, and (5) the LRP2 rs2544390 polymorphism in heavier drinkers vs. abstainers. Quantile-dependent expressivity may also explain the larger genetic effect size of an SLC2A9/PKD2/ABCG2 haplotype for high vs. low intakes of alcohol, chicken, or processed meats. Conclusions Heritability of serum uric acid concentrations is quantile-specific.
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Drapkina OM, Karamnova NS, Kontsevaya AV, Gorny BE, Dadaeva VA, Drozdova LY, Yeganyan RA, Eliashevich SO, Izmailova OV, Lavrenova EA, Lischenko OV, Skripnikova IA, Shvabskaya OB, Shishkova VN. Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.
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Affiliation(s)
- O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - B. E. Gorny
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - L. Yu. Drozdova
- National Medical Research Center for Therapy and Preventive Medicine
| | - R. A. Yeganyan
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. O. Eliashevich
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. A. Lavrenova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Lischenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. B. Shvabskaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. N. Shishkova
- National Medical Research Center for Therapy and Preventive Medicine
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75
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Liddle J, Richardson JC, Hider SL, Mallen CD, Watson L, Chandratre P, Roddy E. 'It's just a great muddle when it comes to food': a qualitative exploration of patient decision-making around diet and gout. Rheumatol Adv Pract 2021; 5:rkab055. [PMID: 34514294 PMCID: PMC8421808 DOI: 10.1093/rap/rkab055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Our aim was to understand whether, why and how patients choose to modify their diets after developing gout. Methods We conducted an inductive thematic secondary analysis of qualitative data from 43 interviews and four focus groups with UK participants with gout (n = 61). Results Participants commonly initiated dietary changes as part of a self-management strategy for gout. Reasons for making such dietary changes included: desperation; a desire for control; and belief that it would be possible to achieve successful management through diet alone; but not weight loss. Participants who did not make changes or who reverted to previous dietary patterns did so because: they believed urate-lowering therapy was successfully managing their gout; medication allowed normal eating; they did not find ‘proof’ that diet would be an effective treatment; or the dietary advice they found was unrealistic, unmanageable or irrelevant. Dietary modification was patient led, but patients would have preferred the support of a health-care professional. Beliefs that diet could potentially explain and modify the timing of flares gave patients a sense of control over the condition. However, the belief that gout could be controlled through dietary modification appeared to be a barrier to acceptance of management with urate-lowering therapy. Conclusions Perceptions about gout and diet play a large role in the way patients make decisions about how to manage gout in their everyday lives. Addressing the reasons why patients explore dietary solutions, promoting the value of urate-lowering therapy and weight loss and drawing on strong evidence to communicate clearly will be crucial in improving long-term clinical management and patient experience.
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Affiliation(s)
- Jennifer Liddle
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Jane C Richardson
- School of Law and Social Justice, University of Liverpool, Liverpool
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Uhlig T, Karoliussen LF, Sexton J, Borgen T, Haavardsholm EA, Kvien TK, Hammer HB. 12-month results from the real-life observational treat-to-target and tight-control therapy NOR-Gout study: achievements of the urate target levels and predictors of obtaining this target. RMD Open 2021; 7:rmdopen-2021-001628. [PMID: 33782189 PMCID: PMC8009238 DOI: 10.1136/rmdopen-2021-001628] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Gout is often not adequately treated, and we aimed to apply urate lowering treatment (ULT) combined with individual information to achieve target serum urate (sUA) in clinical practice, and to identify predictors of achievement of this sUA target. METHODS Patients with a recent gout flare and sUA >360 µmol/L (>6 mg/dL) were consecutively included in a single-centre study and managed with a treat-to-target approach combining nurse-led information about gout with ULT. All patients were assessed with tight controls at baseline, 1, 2, 3, 6, 9 and 12 months including clinical examination, information on demographics, lifestyle, self-efficacy and beliefs about medicines. The treatment target was sUA <360 µmol/L and multivariable logistic regression was used to identify predictors of target attainment with ORs and 95% CIs. RESULTS Of 211 patients (mean age 56.4 years, disease duration 7.8 years, 95% males), 186 completed the 12-month study. Mean sUA levels decreased from baseline mean 500 to 311 µmol/L at 12 months with 85.5% achieving the treatment target. Alcohol consumption at least weekly versus less frequently (OR 0.14; 95% CI 0.04 to 0.55) as well as beliefs in overuse of medicines (OR per unit 0.77; 95 CI 0.62 to 0.94) decreased the chance of reaching the treatment target, while higher self-efficacy for arthritis symptoms (OR 1.49 per 10 units; 95% CI 1.09 to 2.05) increased the likelihood. CONCLUSIONS This study shows that target sUA can be achieved with ULT in most patients. Less self-reported alcohol consumption, low beliefs in overuse of medicines and higher self-efficacy are associated with treatment success.
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Affiliation(s)
- Till Uhlig
- Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Tove Borgen
- Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Espen A Haavardsholm
- Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore K Kvien
- Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Hilde Berner Hammer
- Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Murdoch R, Barry MJ, Choi HK, Hernandez D, Johnsen B, Labrador M, Reid S, Singh JA, Terkeltaub R, Vázquez Mellado J, Dalbeth N. Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) common language definition of gout. RMD Open 2021; 7:rmdopen-2021-001623. [PMID: 33903281 PMCID: PMC8076916 DOI: 10.1136/rmdopen-2021-001623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 12/27/2022] Open
Abstract
Objective To develop a Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) common language definition of gout, with the goal of increasing public understanding and awareness, and ensure consistent and understandable messages about gout. Methods A G-CAN working group that included patients, physicians and nongovernmental organisation (NGO) representatives was formed to develop a common language definition of gout for use with the public, media, healthcare providers and stakeholders. A literature search and interviews with patients, healthcare workers and stakeholders informed development of the definition. Following consultation with G-CAN members and partners, the definition was endorsed by the G-CAN board. Results The G-CAN common language definition of gout describes the epidemiology, pathophysiology, symptoms and impact, risk factors, comorbidities, management and healthcare and workforce considerations. Detailed information is provided to support the content of the definition. After the publication of the English-language version, the definition will be available for translation into other languages by G-CAN members. Conclusion G-CAN has developed a concise and easily understandable statement describing gout in language that can be used in conversations with the lay public, media, NGOs, funders, healthcare providers and other stakeholders.
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Affiliation(s)
- Rachel Murdoch
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Michael J Barry
- Department of Primary Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Hyon K Choi
- Division of Rheumatology Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Brianne Johnsen
- Division of Rheumatology Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Manuel Labrador
- Department of Rheumatology, Hospital General de México, Ciudad de Mexico, Mexico
| | - Susan Reid
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medicine Service, Birmingham VA Medical Center, Birmingham, Alabama, USA
| | - Robert Terkeltaub
- Department of Rheumatology, University of California San Diego, La Jolla, California, USA
| | | | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Chu BBR, Pereira da Cunha JPVV, Marcon JMT, de Arruda Prado LE, Rosa FLS, Leitão JM, Thomaz AC, Kowalski SC, Azevedo VF. Does Disease Activity Influence the Levels of Uric Acid in Psoriatic Arthritis? Open Rheumatol J 2021. [DOI: 10.2174/1874312902115010057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background:
Hyperuricemia is not only associated with the development of gout but also with renal and vascular dysfunction. The prevalence of this condition has already been studied in psoriasis, but there are a few studies that have been carried out in psoriatic arthritis (PsA). Some studies have shown an association with metabolic syndrome, while others with the extent of cutaneous involvement, but there are no studies that have evaluated the disease activity with compound indexes.
Objective:
The aim of the study was to determine if disease activity, measured by different composite scores, influences the levels of uric acid.
Method:
This was a cross-sectional, observational study, which included 52 PsA patients. Clinical assessments included dactylitis, tender and swollen joint counts, Psoriasis Area and Severity Index, Leeds Enthesis Index, Minimal Disease Activity and Disease Activity for Psoriatic Arthritis. Hyperuricemia was defined as serum uric acid levels ≥ 6mg/dL in females and ≥ 7mg/dL in males.
Results:
Among the 52 included patients, 55.76% were female. The mean age was 54.9 ± 11.6 years. Hyperuricemia occurred in 26.92%. Demographic data, diet, comorbidities and medication were similar between patients with and without hyperuricemia. Patients with hyperuricemia had higher waist circumference (p <0.0046). There was no difference in disease activity between groups, either in the isolated items or in the composite indexes. There was a significant difference in uric acid levels according to the classification of chronic kidney disease by estimated glomerular filtration rate (p=0.0016). Individuals using leflunomide had significantly lower levels of uric acid than those who were not using (p=0.0071).
Conclusion:
This study supports the notion that, in PsA, hyperuricemia is more related to metabolic factors than to disease activity.
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Quilis N, Sivera F, Seoane-Mato D, Pérez-Ruiz F, Sánchez-Piedra C, Díaz-González F, Bustabad-Reyes S. Prevalence of gout in the adult general population in Spain: Estimating the proportion of undiagnosed cases. Joint Bone Spine 2021; 89:105257. [PMID: 34325050 DOI: 10.1016/j.jbspin.2021.105257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/13/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To estimate the prevalence of gout in Spain. METHODS Cross-sectional, population-based study of people aged 20 years or older. First, randomly selected individuals were contacted by telephone and rheumatic disease screening questionnaires were conducted. If the first screening was positive, medical records were then reviewed and/or a phone questionnaire was conducted by a rheumatologist, followed by an appointment if necessary. Newly diagnosed cases had to fulfil the ACR/EULAR 2015 criteria. To calculate the prevalence and its 95% CI, the sample design was taken into account and weighing was calculated according to age, sex and geographic origin. RESULTS In all, 4916 individuals were included, 1361 had a positive screening result for gout (59 of them reported a prior diagnosis). Of these, 51 were classified as missing and 95 were classified as gout cases. An additional case was detected through a positive screening for fibromyalgia and Sjögren's syndrome, although a previous gout diagnosis was confirmed by a review of the medical records. Of the 96 gout cases, 31 (32%) were de novo diagnoses. The estimated weighted prevalence of gout was 2.4% (95% CI 1.95-2.95), with a higher prevalence in men (4.55% [95%CI 3.65-5.65]) than women (0.38% [95%CI 0.19-0.76]). CONCLUSION EPISER2016 is the first population-based study to estimate the prevalence of gout in Spain. Undiagnosed patients accounted for a substantial proportion of cases, highlighting the need for population-approaches when estimating the prevalence of infra-diagnosed diseases. Reliable national approaches are key to obtaining accurate estimates of diseases to better aid healthcare and workforce planning.
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Affiliation(s)
- Neus Quilis
- Rheumatology, Hospital General Universitario Elda, Elda, Spain
| | - Francisca Sivera
- Rheumatology, Hospital General Universitario Elda, Elda, Spain; Dept Medicine, Universidad Miguel Hernandez, Elche, Spain.
| | - Daniel Seoane-Mato
- Research Unit (UI), Sociedad Española de Reumatologia (SER), Madrid, Spain
| | | | | | - Federico Díaz-González
- Rheumatology, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain; Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
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Yokose C, McCormick N, Choi HK. Dietary and Lifestyle-Centered Approach in Gout Care and Prevention. Curr Rheumatol Rep 2021; 23:51. [PMID: 34196878 PMCID: PMC9281000 DOI: 10.1007/s11926-021-01020-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW We aim to provide a comprehensive review of the available literature to inform dietary recommendations for patients with gout and hyperuricemia that have the potential to simultaneously lower serum urate and reduce gout morbidity while addressing gout's cardiometabolic comorbidities holistically. RECENT FINDINGS The global burden of gout is rising worldwide, particularly in developed nations as well as in women. Patients with gout are often recommended to follow a low-purine (i.e., low-protein) diet to avoid purine-loading. However, such an approach may lead to increased consumption of unhealthy carbohydrates and fats, which in turn contributes to metabolic syndrome and subsequently raises serum urate levels and leads to adverse cardiovascular outcomes. On the other hand, several well-established diets for cardiometabolic health, such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, also have beneficial effects on relevant gout endpoints. It is important to recognize not only the direct effect of diet on hyperuricemia and gout, but its mediated effect through obesity and insulin resistance. Thus, several preeminent healthy dietary patterns that have proven benefits in cardiometabolic health have the power to holistically address not only gout morbidity but also its associated comorbidities that lead to premature mortality among patients with gout.
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Affiliation(s)
- Chio Yokose
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA.
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA.
| | - Natalie McCormick
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Hyon K Choi
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA
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Szabó Á, Towers A, Newcombe D, Sheridan J. Alcohol use trajectories across the life course: Influences of childhood predictors and consequences for late-life health. Drug Alcohol Depend 2021; 224:108713. [PMID: 33940326 DOI: 10.1016/j.drugalcdep.2021.108713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The cumulative, negative health effects of alcohol consumption are exacerbated in older adulthood. We used a 'life course epidemiology' approach to explore how alcohol use trajectories develop across the lifespan, what early life events influence these trajectories and their associations with late-life health. METHODS Survey data combined with retrospective life course history interviews were collected from 749 non-lifetime alcohol abstainer adults aged 61-81 years (51 % female). Frequency and quantity items of the AUDIT-C assessed alcohol use across each decade of life. Early life factors were childhood socioeconomic status, parental health behaviours, and age of drinking onset. Health outcomes were alcohol-related conditions. RESULTS Latent class growth analysis yielded two life course trajectories for women: consistently infrequent, low quantity drinking (Group 1: 48 %) and increasingly frequent, low quantity drinking (Group 2: 52 %). Men showed three trajectories: consistently infrequent, low quantity drinking (Group 3: 36 %); increasingly frequent, low quantity drinking (Group 4: 51 %); and drinking with increasing frequency and quantity until midlife, after which consumption gradually declined (Group 5: 13 %). Better childhood socioeconomic status was associated with Groups 2 and 4. Later drinking onset was associated with Groups 1 and 3. Parental alcohol misuse, early drinking initiation and childhood socioeconomic adversity were predictive of Group 5. Those in Group 5 were five-to-seven times more likely to have alcohol-related comorbidities. CONCLUSIONS Early life experiences influence life course hazardous alcohol use. Interventions across the life course, from childhood, when drinking may be initiated, through to older adulthood, when sensitivity to alcohol increases, are needed.
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Affiliation(s)
- Ágnes Szabó
- School of Health Sciences, Massey University, New Zealand; School of Health, Victoria University of Wellington, New Zealand.
| | - Andy Towers
- School of Health Sciences, Massey University, New Zealand
| | - David Newcombe
- Centre for Addiction Research, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand; School of Population Health, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand
| | - Janie Sheridan
- Centre for Addiction Research, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand; School of Pharmacy, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand
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Zhang T, Gan S, Ye M, Meng G, Zhang Q, Liu L, Wu H, Gu Y, Zhang S, Wang Y, Wang X, Sun S, Wang X, Zhou M, Jiao H, Jia Q, Song K, Wu Y, Niu K. Association between consumption of ultra-processed foods and hyperuricemia: TCLSIH prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:1993-2003. [PMID: 34119375 DOI: 10.1016/j.numecd.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Emerging evidence suggests that consumption of ultra-processed foods (UPF) plays a role in the development of chronic diseases, but evidence of their influence on hyperuricemia is limited. We therefore designed a cohort study to examine whether UPF consumption increase the risk of hyperuricemia in adults. METHODS AND RESULTS This was a prospective study (n = 18,444) performed in Tianjin, China from 2013 to 2019. Participants that were aged 18 years and over and with no history of hyperuricemia, were followed up for 1-6 years (median follow-up duration = 4.2 years). UPF consumption was assessed by a validated semi-quantitative food frequency questionnaire. Hyperuricemia was defined as serum uric acid levels ≥7.0 mg/dL in males and ≥ 6 mg/dL in females. Multivariable Cox proportional hazards regression models were used to assess the association between UPF consumption and the risk of hyperuricemia. Restricted cubic spline regression was used to estimate the dose-response association between UPF consumption and risk of hyperuricemia. During follow-up period, the incidence of hyperuricemia was 20.3% in general population (27.7% in males and 13.2% in females). In the final multivariate models, the hazard ratios (95% confidence interval) for hyperuricemia across energy adjusted UPF consumption quartiles were 1.00 (reference), 1.04 (0.94, 1.14), 1.11 (1.01, 1.23), 1.16 (1.05, 1.28) (p for trend = 0.02) in general population. CONCLUSIONS This population-based prospective cohort study suggests that increased consumption of UPF is independently associated the risk of hyperuricemia.
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Affiliation(s)
- Tingjing Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shinan Gan
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Mingxu Ye
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yawen Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xing Wang
- The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ming Zhou
- The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Huanli Jiao
- The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiyu Jia
- The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuntang Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
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Kumar M, Manley N, Mikuls TR. Gout Flare Burden, Diagnosis, and Management: Navigating Care in Older Patients with Comorbidity. Drugs Aging 2021; 38:545-557. [PMID: 34105100 DOI: 10.1007/s40266-021-00866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
Gout is the most common form of inflammatory arthritis, and its incidence is highest in middle-aged and older patients. Adding to the diagnostic complexity, up to 50% of patients aged > 65 years present atypically, with subacute oligo- or polyarticular flares. Comorbidity and polypharmacy, common in older populations, affect real-world treatment decisions in gout management, and no specific guidelines are available to address these issues in these at-risk groups. Despite the growing public health burden posed by gout, suboptimal management has led to increased morbidity and substantial healthcare utilization and cost burden, as reflected by an increased incidence of emergency department visits and hospitalizations in recent years. Colchicine, nonsteroidal anti-inflammatory drugs, or glucocorticoids (oral, intraarticular, or intramuscular) should be considered as first-line agents for gout flare management. Urate-lowering therapy, with the goal of lowering and maintaining serum urate concentrations at < 6 mg/dL (< 360 μmol/L), is recommended to achieve optimal outcomes, including regression of tophi, reduction (or elimination) of flares, and reductions in total urate burden. In this review, we summarize the current burden posed by gout and discuss best practices in its diagnosis and management, focusing on best practices in the context of gout flare in older patients with comorbid conditions.
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Affiliation(s)
- Mukund Kumar
- Division of Rheumatology, Department of Internal Medicine, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE, 68198-6270, USA.,Medicine and Research, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Natalie Manley
- Division of Geriatrics, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ted R Mikuls
- Division of Rheumatology, Department of Internal Medicine, University of Nebraska Medical Center, 986270 Nebraska Medical Center, Omaha, NE, 68198-6270, USA. .,Medicine and Research, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.
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84
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Li Y, Shen Z, Zhu B, Zhang H, Zhang X, Ding X. Demographic, regional and temporal trends of hyperuricemia epidemics in mainland China from 2000 to 2019: a systematic review and meta-analysis. Glob Health Action 2021; 14:1874652. [PMID: 33475474 PMCID: PMC7833047 DOI: 10.1080/16549716.2021.1874652] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hyperuricemia (HUA) is becoming a global public health problem and associated with multiple diseases. OBJECTIVE We conducted a systematic review to synthesize the pooled prevalence of HUA in mainland China and delineate its demographic, regional, and temporal trends over the past two decades. METHODS Systematic literature searches of PubMed, SCOPUS, Web of Science, the China National Knowledge Infrastructure (CNKI), and the Wanfang digital database were conducted to screen studies published from 1 January 2000 to 31 August 2019, reporting the prevalence of HUA in mainland China. The search strings were ('hyperuricemia' OR 'hyperuricaemia' OR 'uric acid') AND ('prevalence' OR 'epidemiology') AND 'China'. Article quality was appraised quantitatively from 11 items. Before formal meta-analysis, age-standardized prevalence was transformed. The random-effects model was applied to synthesize the pooled prevalence due to its high heterogeneity. Then we stratified the prevalence estimates by age, gender, area, nationality, and publication year for subgroup analysis. RESULTS Totally 177 eligible studies with a whole population of 2,277,712 were included in the present meta-analysis. The pooled prevalence in mainland China was estimated at 16.4% (95% CI: 15.3%~17.6%). In studies with the onset age at 20 ~ 29 years old, males had a twice times higher HUA prevalence than females (21.5% vs. 8.9%). The prevalence of HUA was 13.7% (11.8%~15.7%) in people aged 15~ years old, 16.5% in 30~ (14.8%~18.4%), 17.9% in 40~ (16.4%~19.5%), 19.4% in 50~ (17.8%~21.0%), 20.5% in 60~ (18.8%~22.3%), and 24.9% in over 70 (22.9%~27.1%). Stratified by regions, southern (25.5%) and southwestern (21.2%) China shared the highest prevalence, and the lowest prevalence was observed in the northwest (12.6%). From 2001 to 2017, the prevalence estimates of HUA steadily climbed from 8.5% to 18.4% with minor fluctuations. Multiple regression revealed that HUA prevalence was positively correlated to the larger sample size, area, advanced onset age, and published year. CONCLUSIONS The last two decades witnessed the rapid growth prevalence of HUA in China. Early screening and personalized health education for HUA need to be given enough attention.
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Affiliation(s)
- Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
| | - Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
| | - Han Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
| | - Xiaoyan Zhang
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University , Shanghai, China.,Shanghai Medical Center of Kidney , Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai, China.,Shanghai Institute of Kidney and Dialysis , Shanghai, China.,Hemodialysis Quality Control Center of Shanghai , China
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Abstract
Gout is a common and treatable disease caused by the deposition of monosodium urate crystals in articular and non-articular structures. Increased concentration of serum urate (hyperuricaemia) is the most important risk factor for the development of gout. Serum urate is regulated by urate transporters in the kidney and gut, particularly GLUT9 (SLC2A9), URAT1 (SLC22A12), and ABCG2. Activation of the NLRP3 inflammasome by monosodium urate crystals with release of IL-1β plays a major role in the initiation of the gout flare; aggregated neutrophil extracellular traps are important in the resolution phase. Although presenting as an intermittent flaring condition, gout is a chronic disease. Long-term urate lowering therapy (eg, allopurinol) leads to the dissolution of monosodium urate crystals, ultimately resulting in the prevention of gout flares and tophi and in improved quality of life. Strategies such as nurse-led care are effective in delivering high-quality gout care and lead to major improvements in patient outcomes.
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Affiliation(s)
- Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand.
| | - Anna L Gosling
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Angelo Gaffo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA
| | - Abhishek Abhishek
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK; Nottingham National Institute for Health Research Biomedical Research Centre, Nottingham, UK
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86
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Limirio LS, Santos HO, Dos Reis AS, de Oliveira EP. Association Between Dietary Intake and Serum Uric Acid Levels in Kidney Transplant Patients. J Ren Nutr 2021; 31:637-647. [PMID: 33931313 DOI: 10.1053/j.jrn.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/22/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association between dietary intake and uric acid (UA) levels in kidney transplant patients (KTPs). METHODS A cross-sectional study was performed with 113 KTPs. Dietary intake assessment was carried out thorough two 24-hour dietary recalls using the 5-step multiple pass method. We evaluated the intake of energy, carbohydrate, total protein, animal protein, vegetable protein, total fat, saturated fat, trans fat, monounsaturated fat, polyunsaturated fat, omega-3 and omega-6 fatty acids, cholesterol, total sugar, added sugars, total fiber, insoluble fiber, soluble fiber, alcohol, caffeine, fructose, glucose, lactose, sucrose, vitamin A, vitamin C, vitamin E, and calcium. The intake of several food groups (portions) was also evaluated. Hyperuricemia was classified as >7.0 and >6 mg/dL for men and women, respectively. RESULTS In odds ratio analyses, the individuals who ingested more vegetable protein (g/kg) and caffeine (mg) presented lower chance to have hyperuricemia. In linear regression, animal protein (g) intake was positively associated (β = 0.011, P = .048), while vegetable protein (g/kg) intake was inversely associated (β = -2.45, P = .047) with serum UA. However, after a multiple linear regression including vegetable and animal protein intakes together, only vegetable protein intake remained associated with UA. The intake of other nutrients and portions of food groups was not associated with UA. All the analyses were adjusted for sex, age, hypertension, body mass index, glomerular filtration rate, use of medicines, and caloric intake misreporting. CONCLUSIONS Vegetable protein and caffeine intakes were inversely associated with UA in KTPs.
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Affiliation(s)
- Larissa S Limirio
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Heitor O Santos
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Aline S Dos Reis
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Erick P de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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87
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Eliseev MS. Comments on the updated recommendations of the American College of Rheumatology (ACR) for the treatment of gout. Lifestyle (part 2). MODERN RHEUMATOLOGY JOURNAL 2021. [DOI: 10.14412/1996-7012-2021-2-83-88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Updated ACR recommendations for the treatment of gout concerning lifestyle are discussed. Factors related to a lifestyle, above all food habits, for many years were of leading importance in the treatment of patients with gout, even after application of effective drugs. The authors of the updated ACR recommendations for the first time offered to reconsider the role of environmental factors in the genesis of gout and objectively assess the possibility of its non-drug treatment. On the one hand, regardless of the activity of the disease, the need for restrictions of the alcohol, purine-rich products and fructose-containing beverages, as well as the decrease of body weight in obese patients and vitamin C usage unviability are confirmed. On the other hand, these recommendations are conditional. Their new version of ACR recommendations is significantly different from both its previous version and other international and national recommendations, including recommendations on the diagnosis and treatment of gout used in the Russian Federation.
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Abstract
Alcohol is recognized a risk factor for increased uric acid and gout flare. The aim of the study was to review the literature in order to find out what is the role of alcohol consumption in pathogenesis of gout. A search in PubMed, Google Scholar, Medline Complete database was performed in January 2021. The databases were searched with the phrases: "uric acid and alcohol," "alcoholic beverages and gout," "hyperuricemia and alcoholic beverages consumption" published between 2000 and 2021. A total of 2642 results were found. The 99 non-duplicate citations were screened. Then 81 articles were excluded after abstract screen. After that 18 articles were retrieved. Eventually 15 articles were included for systematic review. Several authors see the positive correlation between beer or distilled spirits consumption and gout. Some include wine to the list of triggers of gout. Others state that moderate wine consumption protects from gout attacks due to antioxidants and phytoestrogen content. Majority noticed the relationship between episodic alcohol consumption and gout attacks. Episodic alcohol intake triggers gout attacks, regardless of type of alcohol. Thus, individuals with established gout and pre-existing risk factors should limit all types of alcohol intake to prevent gout episodes.
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89
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Liu YR, Tantoh DM, Lin CC, Hsiao CH, Liaw YP. Risk of gout among Taiwanese adults with ALDH-2 rs671 polymorphism according to BMI and alcohol intake. Arthritis Res Ther 2021; 23:115. [PMID: 33858492 PMCID: PMC8048165 DOI: 10.1186/s13075-021-02497-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/29/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Gout stems from both modifiable and genetic sources. We evaluated the risk of gout among Taiwanese adults with aldehyde dehydrogenase-2 (ALDH2) rs671 single nucleotide polymorphism (SNP) according to body mass index (BMI) and alcohol drinking. METHODS We obtained information of 9253 individuals having no personal history of cancer from the Taiwan Biobank (2008-2016) and estimated the association between gout and independent variables (e.g., rs671, BMI, and alcohol drinking) using multiple logistic regression. RESULTS Alcohol drinking and abnormal BMI were associated with a higher risk of gout whereas the rs671 GA+AA genotype was associated with a lower risk. The odds ratios (ORs) and 95% confidence intervals (CIs) were 1.297 and 1.098-1.532 for alcohol drinking, 1.550 and 1.368-1.755 for abnormal BMI, and 0.887 and 0.800-0.984 for GA+AA. The interaction between BMI and alcohol on gout was significant for GG (p-value = 0.0102) and GA+AA (p-value = 0.0175). When we stratified genotypes by BMI, alcohol drinking was significantly associated with gout only among individuals with a normal BMI (OR; 95% CI = 1.533; 1.036-2.269 for GG and 2.109; 1.202-3.699 for GA+AA). Concerning the combination of BMI and alcohol drinking among participants stratified by genotypes (reference, GG genotype, normal BMI, and no alcohol drinking), the risk of gout was significantly higher in the following categories: GG, normal BMI, and alcohol drinking (OR, 95% CI = 1.929, 1.385-2.688); GG, abnormal BMI, and no alcohol drinking (OR, 95% CI, = 1.721, 1.442-2.052); GG, abnormal BMI, and alcohol drinking (OR, 95% CI = 1.941, 1.501-2.511); GA+AA, normal BMI, and alcohol drinking (OR, 95% CI = 1.971, 1.167-3.327); GA+AA, abnormal BMI, and no alcohol drinking (OR, 95% CI = 1.498, 1.256-1.586); and GA+AA, abnormal BMI, and alcohol drinking (OR, 95% CI = 1.545, 1.088-2.194). CONCLUSIONS Alcohol and abnormal BMI were associated with a higher risk of gout, whereas the rs671 GA+AA genotype was associated with a lower risk. Noteworthy, BMI and alcohol had a significant interaction on gout risk. Stratified analyses revealed that alcohol drinking especially among normal-weight individuals might elevate the risk of gout irrespective of the genotype.
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Affiliation(s)
- Yu-Ruey Liu
- Department of Emergency Medicine, Chung-Kang Branch, Cheng Ching Hospital, Taichung City, 407, Taiwan
| | - Disline Manli Tantoh
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
| | - Chuan-Chao Lin
- Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung City, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Chih-Hsuan Hsiao
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
| | - Yung-Po Liaw
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan.
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
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90
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James A, Ke H, Yao T, Wang Y. The Role of Probiotics in Purine Metabolism, Hyperuricemia and Gout: Mechanisms and Interventions. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1904412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Armachius James
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
- Rizhao HUAWEI Institute of Comprehensive Health Industries, Rizhao, China
| | - Hengming Ke
- Department of Biochemistry and Biophysics and Lineberger Comprehensive Centre, The University of North Carolina, Chapel Hill, USA
| | - Ting Yao
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
- Rizhao HUAWEI Institute of Comprehensive Health Industries, Rizhao, China
| | - Yousheng Wang
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing, China
- Rizhao HUAWEI Institute of Comprehensive Health Industries, Rizhao, China
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91
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Roman YM, Lor K, Xiong T, Culhane-Pera K, Straka RJ. Gout prevalence in the Hmong: a prime example of health disparity and the role of community-based genetic research. Per Med 2021; 18:311-327. [PMID: 33787318 DOI: 10.2217/pme-2020-0107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals of distinct Asian backgrounds are commonly aggregated as Asian, which could mask the differences in the etiology and prevalence of health conditions in the different Asian subgroups. The Hmong are a growing Asian subgroup in the United States with a higher prevalence of gout and gout-related comorbidities than non-Hmong. Genetic explorations in the Hmong suggest a higher prevalence of genetic polymorphisms associated with an increased risk of hyperuricemia and gout. History of immigration, acculturation, lifestyle factors, including dietary and social behavioral patterns, and the use of traditional medicines in the Hmong community may also increase the risk of developing gout and lead to poor gout management outcomes. Engaging minorities such as the Hmong population in biomedical research is a needed step to reduce the burden of health disparities within their respective communities, increase diversity in genomic studies, and accelerate the adoption of precision medicine to clinical practice.
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Affiliation(s)
- Youssef M Roman
- Assistant Professor, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia 23298, USA
| | - Kajua Lor
- Associate Professor & Chair, Medical College of Wisconsin, School of Pharmacy, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Txia Xiong
- Clinical Pharmacist, West Side Community Health Services, St. Paul, MN 55106, USA
| | | | - Robert J Straka
- Professor & Department Head, University of Minnesota College of Pharmacy, Minneapolis, Minnesota 55455, USA
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92
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To K, Mak C, Zhang C, Zhou Y, Filbay S, Khan W. The association between alcohol consumption and osteoarthritis: a meta-analysis and meta-regression of observational studies. Rheumatol Int 2021; 41:1577-1591. [PMID: 33745000 PMCID: PMC8316228 DOI: 10.1007/s00296-021-04844-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/11/2021] [Indexed: 01/07/2023]
Abstract
There is conflicting evidence for the association between alcohol consumption and common joint conditions such as Osteoarthritis (OA), which affects millions of people. We sought to determine the true association between alcohol intake and OA. We conducted a PRISMA systematic review and meta-analysis of observational studies that reported associations between alcohol consumption and OA. Pooled estimates of association were represented through odds ratios (ORs). Publication bias was assessed with Funnel and Galbraith plots, and risk of bias was assessed with the Newcastle Ottawa Scale. We included 29 studies and 25,192 subjects with OA and reported an OR between any alcohol consumption and OA of 0.79 (0.68–0.93), suggesting a protective effect. OR of weekly or more frequent use was 0.79 (0.65–0.97). When grouped by covariates, alcohol consumption was negatively associated with radiographic (0.83, 0.70–0.98), hand (0.80, 0.66–0.95) and knee OA (0.85, 0.72–0.99), North American ethnicity and female gender. Subgroup analysis of unadjusted data resulted in an OR of 0.70 (0.55–0.89) but this disappeared upon analysis of studies with data adjusted for any covariate (0.93, 0.78–1.10). Whilst our pooled analysis suggest that weekly or more frequent alcohol consumption was negatively associated with OA, this was not observed when adjusted for confounding factors. Reasons for this include selection bias and lack of longitudinal exposure and adjustment for confounding variables. Therefore, this meta-analysis provides evidence to dispel notions that alcohol use may be protective against OA.
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Affiliation(s)
- Kendrick To
- Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Christopher Mak
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Chen Zhang
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Yuhui Zhou
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Stephanie Filbay
- Department of Physiotherapy, Centre for Health Exercise and Sports Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - Wasim Khan
- Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, CB2 0QQ, UK.
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93
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Abstract
PURPOSE OF REVIEW Although gout's cardinal feature is inflammatory arthritis, it is closely associated with insulin resistance and considered a manifestation of the metabolic syndrome. As such, both gout and hyperuricemia are often associated with major cardiometabolic and renal comorbidities that drive the persistently elevated premature mortality rates among gout patients. To that end, conventional low-purine (i.e., low-protein) dietary advice given to many patients with gout warrant reconsideration. RECENT FINDINGS Recent research suggests that several healthy diets, such as the Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, can drastically improve cardiometabolic risk factors and outcomes. By treating gout as a part of the metabolic syndrome and shifting our dietary recommendations to these healthy dietary patterns, the beneficial effects on gout endpoints should naturally follow for the majority of typical gout cases, mediated through changes in insulin resistance. SUMMARY Dietary recommendations for the management of hyperuricemia and gout should be approached holistically, taking into consideration its associated cardiometabolic comorbidities. Several healthy dietary patterns, many with similar themes, can be tailored to suit comorbidity profiles and personal preferences.
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Affiliation(s)
- Chio Yokose
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Natalie McCormick
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Hyon K. Choi
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA
- Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, MA
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Abstract
Gout is the most common inflammatory arthritis in the United States. Gouty arthritis is associated with significant morbidity and mortality and is caused by hyperuricemia. Gout is effectively managed and potentially cured by decreasing the overall urate burden with serum urate-lowering therapy. When serum urate is maintained at less than 6.0 mg/dL urate deposition is resolved and gout can be cured. Unfortunately, owing to a lack of physician monitoring and dose escalation the majority of patients do not achieve these urate levels.
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Affiliation(s)
- Sarah F Keller
- Department of Rheumatic and Immunologic Diseases, The Cleveland Clinic, 9500 Euclid Avenue A50, Cleveland, OH 44915, USA.
| | - Brian F Mandell
- Department of Rheumatic and Immunologic Diseases, The Cleveland Clinic, 9500 Euclid Avenue A50, Cleveland, OH 44915, USA
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95
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Dhouibi R, Affes H, Salem MB, Moalla D, Marekchi R, Charfi S, Hammami S, Sahnoun Z, Jamoussi K, Zeghal KM, Ksouda K. Creation of an adequate animal model of hyperuricemia (acute and chronic hyperuricemia); study of its reversibility and its maintenance. Life Sci 2021; 268:118998. [PMID: 33417953 DOI: 10.1016/j.lfs.2020.118998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/18/2020] [Accepted: 12/27/2020] [Indexed: 12/30/2022]
Abstract
AIM Hyperuricemia is defined by the European Rheumatology Society as a uric acid level greater than 6 mg/dl (60 mg/l or 360 μmol/l). Our goal was to evaluate the hypouricemic effect of nettle. For this reason, we have first of all try to create an hyperuricemic animal model which is very suitable because at the level of literature there is not an exact model, there are many models and our objective is to set an adequate model. MATERIALS AND METHODS An attempt has been made to test acute and chronic hyperuricemia by varying the duration and method of induction of potassium oxonate. Similarly, attempts have been made to induce chronic hyperuricemia through an animal and vegetable diet. The reversibility of hyperuricemia was tested with a maintenance protocol. KEY FINDINGS For the creation of the hyperuricemia model, it has been shown that acute hyperuricemia cannot be induced by short administration of potassium oxonate and persistent chronic hyperuricemia can be induced only after daily administration of oxonate of potassium by intraperitoneal injection for 15 days. Indeed, hyperuricemia was reversible after stopping the administration of potassium oxonate. The high-purine diet is also capable of inducing chronic hyperuricemia but to a less extent. SIGNIFICANCE After creating an adequate model of hyperuricemia while setting the dose of potassium oxonate, route of administration and duration. A maintenance protocol was followed which subsequently made it possible to deduce that the daily administration of potassium oxonate must be continued to maintain the hyperuricemia.
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Affiliation(s)
- Raouia Dhouibi
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia.
| | - Hanen Affes
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia.
| | - Maryem Ben Salem
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Dorsaf Moalla
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Rim Marekchi
- Laboratory of Biochemistry, CHU Hedi Cheker of Sfax, Tunisia
| | - Slim Charfi
- Department of Anatomopathology, CHU Habib Bourguiba of Sfax, Tunisia
| | - Serria Hammami
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Zouheir Sahnoun
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Kamel Jamoussi
- Laboratory of Biochemistry, CHU Hedi Cheker of Sfax, Tunisia
| | - Khaled Mounir Zeghal
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Kamilia Ksouda
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Tunisia
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Dedov II, Shestakova MV, Melnichenko GA, Mazurina NV, Andreeva EN, Bondarenko IZ, Gusova ZR, Dzgoeva FK, Eliseev MS, Ershova EV, Zhuravleva MV, Zakharchuk TA, Isakov VA, Klepikova MV, Komshilova KA, Krysanova VS, Nedogoda SV, Novikova AM, Ostroumova OD, Pereverzev AP, Rozhivanov RV, Romantsova TI, Ruyatkina LA, Salasyuk AS, Sasunova AN, Smetanina SA, Starodubova AV, Suplotova LA, Tkacheva ON, Troshina EA, Khamoshina MV, Chechelnitskaya SM, Shestakova EA, Sheremet’eva EV. INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES". OBESITY AND METABOLISM 2021; 18:5-99. [DOI: 10.14341/omet12714] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - M. S. Eliseev
- Research Institute of Rheumatogy named after V.A. Nasonova
| | | | | | | | - V. A. Isakov
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | - M. V. Klepikova
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - A. M. Novikova
- Research Institute of Rheumatogy named after V.A. Nasonova
| | - O. D. Ostroumova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - A. P. Pereverzev
- Russian National Research Medical University named after N.I. Pirogov
| | | | | | | | | | - A. N. Sasunova
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | | | | | | | - O. N. Tkacheva
- Russian National Research Medical University named after N.I. Pirogov
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97
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Tang YM, Zhang L, Zhu SZ, Pan JJ, Zhou SH, He TJ, Li Q. Gout in China, 1990-2017: the Global Burden of Disease Study 2017. Public Health 2021; 191:33-38. [PMID: 33482625 DOI: 10.1016/j.puhe.2020.06.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the gout burden and risk factors in China from 1990 to 2017. STUDY DESIGN The Global Burden of Disease (GBD) Study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS We used the results from the GBD Study 2017 to compare disability-adjusted life years (DALYs), prevalence, incidence, and risk factors of gout in China. The median of the percentage change and 95% uncertainty intervals were determined for the period between 1990 and 2017. RESULTS The age-standardized DALY rate, prevalence, and incidence increased 6.92%, 6.88%, and 6.16%, respectively, in China from 1990 to 2017. Although the rates of gout both globally and in China were increasing, the range of change for males in China was larger than that of the global level. All risk factors combined accounted for 30.04% of gout DALYs in 2017. The leading risk factors for gout DALYs were high body mass index and impaired kidney function, and the proportion of high body mass index increased significantly from 10.67% to 24.31%, whereas the proportion of impaired kidney function remained basically unchanged. CONCLUSIONS The age-standardized DALY rate, prevalence, and incidence in China have increased progressively since 1990. Increasing attention on body weight management should be prioritized for controlling the rising prevalence of gout in the young and middle-aged population.
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Affiliation(s)
- Y M Tang
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - L Zhang
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - S Z Zhu
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - J J Pan
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - S H Zhou
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - T J He
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Q Li
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China.
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98
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Qi J, Dai X, Zhou B, Su Y, Xie Z, Liu D. Association between Lipid Profiles and Serum Urate: A Cross-Sectional Study in Southwestern China. Int J Endocrinol 2021; 2021:2741131. [PMID: 34306070 PMCID: PMC8285201 DOI: 10.1155/2021/2741131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/29/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The relationship between lipid profiles and serum urate has not been fully investigated. This study aims to investigate the sex- and age-specific association between lipid profiles and serum urate. METHODS This was a cross-sectional study involving 122,351 participants aged 18-99 years from a check-up centre in Southwestern China. Generalized additive models and smooth curve fitting were conducted to explore the association between components of lipid profiles and serum urate. Furthermore, multivariate linear and logistic regression models were also performed. RESULTS In generalized additive models, the fitted smoothing curves showed that serum urate fluctuated in a small range with total cholesterol, LDL-C, or HDL-C raising. After adjusting for confounders, the differences in serum urate progressively increased with raising serum triglycerides quartiles. The likelihood (odds ratio, OR) for developing serum urate > 420 μmol/L significantly increased in the highest quartile of triglycerides than in the lowest quartile, in hypertriglyceridemia than in normal triglycerides, and with 1 mmol/L increment in triglycerides in all sex- and age-specific groups. Furthermore, the increased OR (95% confidence interval) was higher in females than in males compared with their respective controls. CONCLUSIONS Serum urate and the likelihood for developing serum urate >420 μmol/L increased with triglycerides raising. Females were in a higher likelihood for developing serum urate >420 μmol/L than males with raising triglycerides. With changes in total cholesterol, LDL-C, or HDL-C, serum urate fluctuated in a small range.
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Affiliation(s)
- Jiying Qi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojuan Dai
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Binbin Zhou
- Department of Rheumatology, Xiamen Hospital, Zhongshan Hospital, Fudan University, Xiamen, Fujian, China
| | - Yang Su
- Clinical Laboratory, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Zhen Xie
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- Department of Dermatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongmei Liu
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
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99
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Kiltz U, Buschhorn-Milberger V, Vaupel K, Braun J. Gicht: aktuelle Epidemiologie, Komorbiditäten, Komplikationen
und sozioökonomische Konsequenzen. AKTUEL RHEUMATOL 2020. [DOI: 10.1055/a-1301-1793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ZusammenfassungDie Gicht gehört neben der rheumatoiden Arthritis zu den
häufigsten Ursachen von Gelenkentzündungen. Als metabolisch
bedingte Erkrankung geht sie meist mit Hyperurikämie und der
Ablagerung von Uratkristallen in Gelenken, Sehnen und Weichteilgeweben
einher, wodurch Entzündungszustände ausgelöst werden
können. Die Gichtarthritis tritt weltweit insbesondere in den
Industrieländern mit steigender Prävalenz auf (weltweit
0,6%), wobei die größte Häufigkeit bei den
Maoris in Ozeanien (bis zu 10%) gemessen wurde. In Deutschland tritt
die Gicht altersabhängig mit einer Prävalenz von
1,63% auf, wobei Männer ungefähr dreimal so
häufig wie Frauen betroffen sind. Kardiovaskuläre und vor
allem renale Komorbiditäten können zu vermehrten
Komplikationen und einer erhöhten Sterblichkeit von Patienten mit
Gicht führen. Grundsätzlich haben Gichtpatienten eine
erhöhte Mortalität im Vergleich zur
Gesamtbevölkerung. Die zunehmende Inzidenz führt zu
steigenden Gesundheitskosten, besonders durch vermehrte Hospitalisierungen.
Darüber hinaus wurden bei Gichtpatienten mehr
Arbeitsunfähigkeitstage sowie reduzierte Erwerbsfähigkeit
mit entsprechenden volkswirtschaftlichen Konsequenzen nachgewiesen.
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Affiliation(s)
- Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Deutschland
- Medizinische Fakultät, Ruhr-Universität Bochum, Bochum,
Deutschland
| | - Verena Buschhorn-Milberger
- Rheumazentrum Ruhrgebiet, Herne, Deutschland
- Medizinische Fakultät, Ruhr-Universität Bochum, Bochum,
Deutschland
| | - Kristina Vaupel
- Rheumazentrum Ruhrgebiet, Herne, Deutschland
- Medizinische Fakultät, Ruhr-Universität Bochum, Bochum,
Deutschland
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet, Herne, Deutschland
- Medizinische Fakultät, Ruhr-Universität Bochum, Bochum,
Deutschland
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100
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Abstract
ZusammenfassungMit steigenden Harnsäurewerten steigt das Risiko einer Gicht. Da die Harnsäure-Homöostase von zahlreichen Lebensstilfaktoren beeinflusst wird, ist das Auftreten einer Gicht fast immer auch mit der Lebensweise assoziiert. Lange schon ist bekannt, dass die Zufuhr purinreicher Lebensmittel (z. B. Fleisch, Meeresfrüchte) über vermehrte Harnsäurebildung aus exogen zugeführten Purinen zu Gichtanfällen führen kann. Auch Fruktose-haltige Getränke haben über einen vermehrten Abbau von ATP bei der Verstoffwechslung von Fruktose eine Hyperurikämie zur Folge, wogegen bei vermehrter Alkoholzufuhr und Adipositas eine verminderte renale Harnsäureausscheidung für die Hyperurikämie ursächlich ist. Einige Lebensmittel (z. B. Milch, Kaffee) scheinen einen harnsäuresenkenden Effekt zu haben und können Patienten explizit empfohlen werden. Mit Blick auf den Lebensstil spielen jedoch nicht nur Ernährungsfaktoren (Lebensmittel) eine wichtige Rolle. So kommt es beim aktuell sehr populären Heilfasten durch die entstehende Ketose und häufig gleichzeitig zu geringer Flüssigkeitszufuhr zu einer verminderten Harnsäureausscheidung über die Niere und konsekutiv Harnsäureanstieg. Auch Extremsport wie Marathon stellt aufgrund der katabolen Stoffwechsellage (Ketose) und hohen mechanischen Belastung (Mikrotraumata) bereits arthrotisch vorgeschädigter Gelenke einen Risikofaktor für das gehäufte Auftreten von Gichtanfällen dar. Patienten mit einer Hyperurikämie sollten als Basismaßnahme immer über eine mögliche Ernährungsumstellung beraten werden, zumal die Hyperurikämie eng mit dem metabolischen Syndrom assoziiert ist, häufigen Stoffwechselkrankheiten wie Diabetes mellitus, Hyperlipidämien und Adipositas, die ebenfalls durch eine Lebensstilmodifikation günstig zu beeinflussen sind. Eine manifeste (langjährige) Gicht kann allerdings durch eine alleinige Ernährungsumstellung nur selten erfolgreich behandelt werden. Der Zusammenhang zwischen Lebensstil und Gicht ist seit Jahrhunderten bekannt. Leider beschränken sich die wenigen Studien zu diesem Thema meist auf epidemiologische Erhebungen, über die in dieser Arbeit eine Übersicht gegeben werden soll.
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