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痛风与高尿酸血症:关于其合并症及临床意义的叙述性综述

Gout and Hyperuricemia: A Narrative Review of Their Comorbidities and Clinical Implications.

作者信息

Timsans Janis, Palomäki Antti, Kauppi Markku

机构信息

Department of Rheumatology, Päijät-Häme Central Hospital, Wellbeing Services County of Päijät-Häme, 15850 Lahti, Finland.

Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland.

出版信息

J Clin Med. 2024 Dec 13;13(24):7616. doi: 10.3390/jcm13247616.

Abstract

Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate crystals in the joints due to elevated serum uric acid levels. Its prevalence and associated healthcare burden have been rising in recent decades, a trend expected to continue. It is crucial to recognize that gout and hyperuricemia are not merely causes of painful joint flares, but systemic metabolic disorders linked to a broad spectrum of comorbidities such as cardiovascular diseases, chronic kidney disease, diabetes, insulin resistance, steatotic liver disease, osteoarthritis, and respiratory and eye diseases. Numerous risk factors for gout and hyperuricemia have been identified, with recent research uncovering further associations with other conditions. To optimize patient outcomes, gout and hyperuricemia must be addressed through a holistic approach that accounts for these risk factors while providing comprehensive management of related comorbidities affecting various organ systems. This review summarizes the current knowledge on the risk factors, comorbidities, and clinical implications of gout and hyperuricemia. Future research should focus on improving patient outcomes by tailoring treatments individually and addressing the underlying metabolic comorbidities of gout with multimodal treatment.

摘要

痛风是炎症性关节炎最常见的形式,由血清尿酸水平升高导致单钠尿酸盐晶体在关节中沉积引起。近几十年来,其患病率及相关医疗负担一直在上升,且这一趋势预计将持续。必须认识到,痛风和高尿酸血症不仅是关节疼痛发作的原因,更是与一系列共病相关的全身性代谢紊乱,这些共病包括心血管疾病、慢性肾病、糖尿病、胰岛素抵抗、脂肪性肝病、骨关节炎以及呼吸道和眼部疾病。已确定了痛风和高尿酸血症的众多危险因素,近期研究还发现了与其他病症的进一步关联。为优化患者治疗效果,必须通过整体方法来处理痛风和高尿酸血症,该方法要考虑到这些危险因素,同时对影响各个器官系统的相关共病进行全面管理。本综述总结了关于痛风和高尿酸血症的危险因素、共病及临床意义的现有知识。未来的研究应专注于通过个体化治疗以及采用多模式治疗解决痛风潜在的代谢性共病来改善患者治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1798/11678569/2a96829eaa16/jcm-13-07616-g001.jpg

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