These recommendations are based on the consensus of clinical experts from a wide range of disciplines taking available evidence into account while balancing the benefits and risks of nonpharmacological, pharmacological, and surgical treatment modalities, and incorporating their preferences and values. Different backgrounds in terms of patient education or drug availability in different countries were not evaluated but will be important.
Antiphospholipid antibodies are commonly related to connective tissue disorders, the use of certain drugs, and infection. It is thought that antiphospholipid syndrome (APS) is associated primarily with connective tissue disorders. We describe a healthy young male who had an episode of APS that was associated with cytomegalovirus infection and who developed mesenteric and femoropopliteal thrombosis. He responded well to treatment with anticoagulants; 6 months after the onset of APS, IgM and IgG anticardiolipin antibody titers declined. We point out the importance of screening for infectious agents in cases of APS; if the agents are identified, APS may be transitory.
Background: Hyperuricemia is emerging as a potential biomarker and a predictor for metabolic syndrome (MetS) and its related complications.Objectives: We aimed this study to investigate the risk factors of hyperuricemia, particularly, the association of hyperuricemia with MetS and general obesity. Methods: We performed multivariate logistic regression analyses using the 2016 Korea National Health and Nutrition Examination Survey (KNHANES) data collected in a representative sample of Korean adults. Hyperuricemia was defined by serum uric acid level !7.0 mg/dl for men and !6.0 mg/ dl for women. General obesity was based on body mass index (BMI) !25 kg/m 2 . Results: Among a total of 5,591 Korean adult participants, 685 (12.3%) individuals were classified as having hyperuricemia. Hyperuricemia was significantly associated with MetS in men (Odd ratio (OR): 1.74, 95% CI: 1.29-2.34) and women (OR: 2.47, 95% CI: 1.55-3.93) after adjustments for age, sex, smoking, alcohol, exercise, BMI and estimated glomerular filtration rate (eGFR). General obesity was also independently related to hyperuricemia in both sex (OR: 1.70, 95% CI: 1.31-2.19 in men, OR: 3.73, 95% CI: 2.57-5.41 in women). Among the components of MetS, elevated blood pressure, elevated triglyceride and reduced HDL-cholesterol in men, and increased waist circumference, hyperglycemia, elevated triglyceride in women were risk factors for hyperuricemia. In subgroup analyses, the presence of concomitant MetS and general obesity posed strikingly higher risk for hyperuricemia among women (OR: 7.24, 95% CI: 4.56-11.50 in women, versus, OR: 2.90, 95% CI: 2.12-3.96 in men) when compared to individuals free of neither conditions (OR: 1.00, referent). In addition, the risk of hyperuricemia has increased up to 6-fold by the presence of MetS and general obesity among young adults aged less than 40 years old. Conclusion: Hyperuricemia was independently associated with MetS and general obesity, regardless of sex. These increases in risk of hyperuricemia were more prominent in women. Among women, those who had both MetS and general obesity were at nearly 7-fold increased risk for hyperuricemia compared to those without both conditions. It may be considered to incorporate hyperuricemia as one of the components of MetS.
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