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Liu W, Dong P, Li C, Guo W, Zhao K, Man S, Zhang L, Wu H, Song H. Clinical implications of persistent joint pain after gout flare. REUMATOLOGIA CLINICA 2024; 20:291-296. [PMID: 38991822 DOI: 10.1016/j.reumae.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/05/2024] [Accepted: 03/10/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES A subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis. METHODS We analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares. RESULTS A total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (P<0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% vs. 21.1%) and bone erosion (18.6% vs. 8.6%) (P<0.05). Higher UA and lower TBil were found in patients with persistent joint pain (P<0.001). Hypertension (54.9% vs. 38.7%) and metabolic syndrome (58.8% vs. 46.4%) were both more frequent in patients with persistent joint pain (P<0.05). TBil was negatively correlated with the incidence of persistent joint pain (P<0.001, r=-0.190), UA values (P<0.001, r=-0.125), and metabolic syndrome scores (P<0.001, r=-0.192). A correlation curve was fitted using LOESS (locally weighted region). CONCLUSION Persistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.
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Affiliation(s)
- Wei Liu
- Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Peng Dong
- Changzhou Xitaihu Institute for Frontier Technology of Cell Therapy, Changzhou, China
| | - Chunyan Li
- Department of Clinical Laboratory, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Wen Guo
- Department of Ultrasound, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Kaiping Zhao
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Siliang Man
- Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Liang Zhang
- Department of Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Husheng Wu
- Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Hui Song
- Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
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Tsai YS, Lee YH, Ko MY. Letter to the editor regarding "urate-lowering therapy for patients with gout on hemodialysis". Int J Rheum Dis 2023; 26:177-178. [PMID: 36250780 DOI: 10.1111/1756-185x.14469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Yung-Shun Tsai
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yung-Heng Lee
- Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.,Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu, Taiwan.,Department of Recreation and Sport Management, Shu-Te University, Kaohsiung, Taiwan
| | - Meng-Yu Ko
- Division of Gastroenterology and Hepatology, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Zhang L, An K, Mou X, Zhang M, Su Q, Li S. Effect of Urate-Lowering Therapy on the Progression of Kidney Function in Patients With Asymptomatic Hyperuricemia: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 12:795082. [PMID: 35115941 PMCID: PMC8804353 DOI: 10.3389/fphar.2021.795082] [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: 10/14/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Hyperuricemia is involved in the risk of chronic kidney disease (CKD). However, whether urate-lowering therapy (ULT) can influence the progression of kidney function in patients with asymptomatic hyperuricemia is still controversial. We conducted a systematic review and meta-analysis to evaluate the effect of ULT on the progression of kidney function in asymptomatic hyperuricemia patients. Methods: The MEDLINE, EMBASE and Cochrane databases were searched without language, national or ethnic restrictions for randomized controlled trials published prior to November 30, 2020, that compared ULT with controlled therapy in patients with asymptomatic hyperuricemia. Results: Eleven studies were included for qualitative synthesis. ULT did not ameliorate eGFR slopes (WMD 0.36 ml/min/1.73 m2 per year, 95% CI: −0.31, 1.04), or lead to reductions in kidney events (RR 1.26; 95% CI: 0.80, 2.00) or all-cause mortality (RR 1.00; 95% CI: 0.65, 1.55), although ULT resulted in a decrease in serum uric acid levels (WMD −2.73 mg/dl; 95% CI: −3.18, −2.28) and lowered the incidence of gout episodes (0.9 vs 2.7%, RR 0.38; 95% CI: 0.17, 0.86). Conclusion: In patients with asymptomatic hyperuricemia, ULT did not decay the progression of kidney function. Long-term and larger sample studies are needed to verify the results. Systematic Review Registration: [www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42020204482].
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Affiliation(s)
- Lin Zhang
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Kang An
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Mou
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Mei Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qiaoli Su
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Shuangqing Li
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
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Wang ZB, Jiang SL, Liu SB, Peng JB, Hu S, Wang X, Zhuo W, Liu T, Guo JW, Zhou HH, Yang ZQ, Mao XY, Liu ZQ. Metabolomics of Artichoke Bud Extract in Spontaneously Hypertensive Rats. ACS OMEGA 2021; 6:18610-18622. [PMID: 34337201 PMCID: PMC8319930 DOI: 10.1021/acsomega.1c01135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/05/2021] [Indexed: 05/10/2023]
Abstract
Hypertension adversely affects the quality of life in humans across modern society. Studies have attributed increased reactive oxygen species production to the pathophysiology of hypertension. So far, a specific drug to control the disease perfectly has not been developed. However, artichoke, an edible vegetable, plays an essential role in treating many diseases due to its potent antioxidant activities. The objective of this study is to evaluate the effect of artichoke bud extract (ABE) on heart tissue metabolomics of hypertensive rats. Spontaneously hypertensive rats and Wistar-Kyoto (WKY) rats were divided into six groups, then exposed to different doses comprising ABE, Enalapril Maleate, or 1% carboxylmethyl cellulose for 4 weeks. Their blood pressures were recorded at 0, 2, 3, and 4 weeks after the start of the test period. Thereafter, all rats were anesthetized, and blood was collected from their cardiac apexes. Then, we measured the levels for 15 kinds of serum biochemical parameters. An established orthogonal partial least square-discriminant analysis model completed the metabolomic analysis. Hypertensive rats in the ABE group exhibited well-controlled blood pressure, relative to those in the model group. Specifically, artichoke significantly lowered serum levels for total protein (TP), albumin (ALB), and uric acid (UA) in the hypertensive rats. This effect involved the action of eight metabolites, including guanine, 1-methylnicotinamide, p-aminobenzoic acid, NAD, NADH, uridine 5'-monophosphate, adenosine monophosphate, and methylmalonic acid. Collectively, these findings suggest that ABE may play a role in affecting oxidative stress and purine, nicotinate, and nicotinamide metabolism.
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Affiliation(s)
- Zhi-Bin Wang
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Shi-Long Jiang
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Shao-Bo Liu
- Department
of Pharmacy, Xiangya Hospital, Central South
University, Changsha 410008, P. R. China
| | - Jing-Bo Peng
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Shuo Hu
- Department
of Nuclear Medicine and Key Laboratory of Biological Nanotechnology
of National Health Commission, Xiangya Hospital, Central South University, Changsha 410008, P. R. China
| | - Xu Wang
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Wei Zhuo
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Tong Liu
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Ji-Wei Guo
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Hong-Hao Zhou
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Zhi-Quan Yang
- Department
of Neurosurgery, Xiangya Hospital, Central
South University, Changsha 410008, P. R. China
- . Phone: +86 731 89753845. Fax: +86 731 82354476
| | - Xiao-Yuan Mao
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
| | - Zhao-Qian Liu
- Department
of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics,
and National Clinical Research Center for Geriatric Disorders, Xiangya
Hospital, Central South University, Changsha 410008, P. R. China
- Institute
of Clinical Pharmacology, Engineering Research Center for Applied
Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha 410078, P. R. China
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