González-Senac Nicolás M, Bailén Rebeca, Torres Rosa J, de Miguel Eugenio, Puig Juan G
a Division of Internal Medicine, Metabolic-Vascular Unit , La Paz University Hospital.
Nucleosides Nucleotides Nucleic Acids. 2014;33(4-6):185-91. doi: 10.1080/15257770.2013.853785.
Primary gout has traditionally been associated with obesity, arterial hypertension, and abnormal lipid and glucose homeostasis, but we do not know the prevalence of these vascular risk factors in patients with primary gout from a Mediterranean country.
All patients with primary gout and 2 or more acute arthritis episodes documented by a physician were selected for the study. The diagnosis of MS required ≥3 criteria (ATP III). Patients were classified in two groups: decreased (underexcretors) and normal (normoexcretors) uric acid excretion related to serum urate levels.
One hundred and four patients (mean age, 59 years; 100 males) with primary gout were included in the study. MS was diagnosed in 38 subjects (37%). The most frequent triad defining MS was an increased waist circumference, blood pressure, and trygliceride levels. The prevalence of type 2 diabetes mellitus (T2D) was significantly higher in patients with the MS (21/38, 55%) as compared with subjects without the MS (3/66, 5%; p<0.001). Mean serum urate level in patients with and without MS was identical (8.1 mg/dL), but mean 24-hour uric acid excretion was significantly lower in the former than in the latter (444±110 mg/24-hour/1,73 m2 versus 546±221 mg/day/1,73 m2; p=0.009).
The condition of the MS occurs in about one-third of the patients with primary gout. Increased waist circumference, blood pressure, and triglycerides levels is the most frequent MS triad. Diminished urinary uric acid excretion is more severe in gout patients with the MS.
原发性痛风传统上与肥胖、动脉高血压以及脂质和葡萄糖稳态异常相关，但我们并不清楚来自地中海国家的原发性痛风患者中这些血管危险因素的患病率。
选取所有经医生记录有2次或更多次急性关节炎发作的原发性痛风患者进行研究。代谢综合征（MS）的诊断需要≥3条标准（ATP III）。患者根据血清尿酸水平分为两组：尿酸排泄减少组（排泄过少者）和正常尿酸排泄组（排泄正常者）。
104例原发性痛风患者（平均年龄59岁；100例男性）纳入研究。38例患者（37%）被诊断为代谢综合征。定义代谢综合征最常见的三联征是腰围增加、血压升高和甘油三酯水平升高。与无代谢综合征的患者相比，代谢综合征患者中2型糖尿病（T2D）的患病率显著更高（21/38，55% 对比 3/66，5%；p<0.001）。有和无代谢综合征患者的平均血清尿酸水平相同（8.1mg/dL），但前者的平均24小时尿酸排泄量显著低于后者（444±110mg/24小时/1.73m² 对比 546±221mg/天/1.73m²；p=0.009）。
约三分之一的原发性痛风患者存在代谢综合征。腰围增加、血压升高和甘油三酯水平升高是最常见的代谢综合征三联征。代谢综合征的痛风患者尿酸排泄减少更为严重。
