Dept of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway.
RMD Open. 2022 Jul;8(2). doi: 10.1136/rmdopen-2022-002348.
Gout is of unknown reason associated with cardiovascular disease. Ultrasound is sensitive for detecting crystal deposition and plasma calprotectin is a sensitive inflammatory marker. This study explores the associations between crystal deposition, inflammation and carotid artery pathology.
A cross-sectional analysis of baseline assessments from the NOR-Gout study was undertaken. Crystal deposition was assessed by ultrasound (double contour, tophi, aggregates) and dual-energy CT (DECT) and laboratory assessments included plasma calprotectin. The carotid arteries were bilaterally examined for carotid intima-media thickness (cIMT) and presence of plaques. Spearman correlations, Mann-Whitney tests and linear regression analyses were used to explore associations between crystal deposition, inflammatory markers,and carotid pathology.
202 patients with intercritical gout (95.5% men, mean (SD) age 56.5 (13.8) years, disease duration 7.9 (7.7) years) were included. Calprotectin was correlated with all scores of crystal deposition by ultrasound (r=0.26-0.32, p<0.001) and DECT (r=0.15, p<0.05). cIMT was correlated with sum score aggregates (r=0.18-0.22, p<0.05). Patients with large tophi had higher levels of calprotectin as well as more frequent carotid plaque (p<0.05).
Study findings point towards crystal deposition contributing to subclinical inflammation with subsequent vascular implications. However, future longitudinal studies are needed to confirm such causal relationships.
痛风是一种病因不明的疾病，与心血管疾病有关。超声检查对晶体沉积敏感，血浆钙卫蛋白是一种敏感的炎症标志物。本研究探讨了晶体沉积、炎症与颈动脉病理之间的关系。
对 NOR-Gout 研究的基线评估进行了横断面分析。通过超声（双轮廓、痛风石、聚集物）和双能 CT（DECT）评估晶体沉积，实验室评估包括血浆钙卫蛋白。双侧检查颈动脉内膜-中层厚度（cIMT）和斑块的存在。使用 Spearman 相关分析、Mann-Whitney 检验和线性回归分析来探讨晶体沉积、炎症标志物与颈动脉病变之间的关系。
共纳入 202 例间歇期痛风患者（95.5%为男性，平均（SD）年龄 56.5（13.8）岁，病程 7.9（7.7）年）。钙卫蛋白与超声（r=0.26-0.32，p<0.001）和 DECT（r=0.15，p<0.05）所有晶体沉积评分均相关。cIMT 与聚集物总分（r=0.18-0.22，p<0.05）相关。大痛风石患者钙卫蛋白水平更高，颈动脉斑块更常见（p<0.05）。
研究结果表明，晶体沉积可能导致亚临床炎症，进而影响血管。然而，需要进一步的纵向研究来证实这种因果关系。
