Choi Sang Tae, Kim Jin Su, Song Jung-Soo
Division of Rheumatology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2014 Jun;29(6):788-92. doi: 10.3346/jkms.2014.29.6.788. Epub 2014 May 30.
Hyperhomocysteinemia is one of the important factors of the cardiovascular disease, and gout is well known to be associated with cardiovascular disease. There are a few reports on the serum homocysteine (Hcy) levels in patients with gout, however, the results showed discrepancies. In this study, we measured Hcy levels in patients with gout and examined factors associated with the levels of serum Hcy. Ninety-one male patients with gout and 97 age-matched healthy male controls were enrolled in the study. Serum uric acid levels were not significantly different between gout and healthy control groups. However, serum Hcy levels were significantly higher in patients with gout compared to controls (13.96 ± 4.05 µM/L vs 12.67 ± 3.52 µM/L, P=0.035). In gout group, patients with 1-2 stages of chronic kidney disease (CKD) had significantly lower serum Hcy than those with 3-5 stages of CKD (13.15 ± 3.46 µM/L vs 17.45 ± 4.68 µM/L, P<0.001). Multivariate linear analysis revealed an inverse association between serum Hcy and estimated glomerular filtration rate (eGFR) (β=-0.107, P<0.001). In conclusion, serum Hcy was elevated in male patients with gout. Hyperhomocysteinemia was not correlated with serum uric acid, but it was inversely associated with impaired renal function.
高同型半胱氨酸血症是心血管疾病的重要因素之一,而痛风与心血管疾病的关联也广为人知。关于痛风患者血清同型半胱氨酸(Hcy)水平的报道较少,然而,结果存在差异。在本研究中,我们测量了痛风患者的Hcy水平,并检查了与血清Hcy水平相关的因素。91例男性痛风患者和97例年龄匹配的健康男性对照者纳入本研究。痛风组和健康对照组的血清尿酸水平无显著差异。然而,痛风患者的血清Hcy水平显著高于对照组(13.96±4.05µM/L对12.67±3.52µM/L,P=0.035)。在痛风组中,慢性肾脏病(CKD)1 - 2期患者的血清Hcy显著低于3 - 5期患者(13.15±3.46µM/L对17.45±4.68µM/L,P<0.001)。多变量线性分析显示血清Hcy与估计肾小球滤过率(eGFR)呈负相关(β=-0.107,P<0.001)。总之,男性痛风患者血清Hcy升高。高同型半胱氨酸血症与血清尿酸无关,但与肾功能受损呈负相关。