Department of Internal Medicine, Trakya University Medical Faculty, Edirne, Turkey.
Rheumatol Int. 2012 Jun;32(6):1769-73. doi: 10.1007/s00296-011-1900-4. Epub 2011 Mar 27.
We evaluated the incidence of subclinical atherosclerosis and associated factors in our gouty arthritis patients. We included 55 gouty arthritis patients diagnosed at our center within the last 4 years. The control group included 41 patients with rheumatoid arthritis (RA) and 34 patients with asymptomatic hyperuricemia (AHU). Atherosclerotic risk factors were determined in all subjects. Carotid intima-media thickness (IMT) and the presence of plaques were evaluated by B-mode ultrasonography. The carotid IMT in gouty arthritis patients (0.730 ± 0.19) was significantly higher than in AHU subjects (0.616 ± 0.12) (P = 0.004) and tended to be higher than the RA group (0.669 ± 0.17) (P = 0.1). Atheromatous plaques were significantly more frequent in gouty arthritis patients (16 cases, 29.1%) than in RA patients (5 cases, 12.2%) and AHU subjects (3 cases, 8.8%) (P values, 0.05 and 0.023). Gout patients with plaques were older (P = 0.006) and tended to have tophi more frequently (P = 0.06). Logistic regression analysis showed that age (OR: 1.3, 95% CI: 1.02-1.54) and the presence of tophi (OR: 12.5, 95% CI: 1.2-140) were independent risk factors for the presence of plaques. Gouty arthritis bears a higher risk of atherosclerosis than both RA and AHU.
我们评估了我们痛风性关节炎患者亚临床动脉粥样硬化的发生率及其相关因素。我们纳入了在过去 4 年内我院确诊的 55 例痛风性关节炎患者。对照组包括 41 例类风湿关节炎（RA）患者和 34 例无症状高尿酸血症（AHU）患者。所有受试者均确定了动脉粥样硬化危险因素。通过 B 型超声评估颈动脉内膜中层厚度（IMT）和斑块的存在。痛风性关节炎患者的颈动脉 IMT（0.730±0.19）明显高于 AHU 组（0.616±0.12）（P=0.004），且倾向于高于 RA 组（0.669±0.17）（P=0.1）。动脉粥样硬化斑块在痛风性关节炎患者中明显更为常见（16 例，29.1%），明显多于 RA 患者（5 例，12.2%）和 AHU 患者（3 例，8.8%）（P 值分别为 0.05 和 0.023）。有斑块的痛风患者年龄更大（P=0.006），且更倾向于频繁出现痛风石（P=0.06）。Logistic 回归分析显示，年龄（OR：1.3，95%CI：1.02-1.54）和痛风石的存在（OR：12.5，95%CI：1.2-140）是存在斑块的独立危险因素。痛风性关节炎发生动脉粥样硬化的风险高于 RA 和 AHU。
