Hyperuricemia, i.e. increased serum uric acid (UA) concentration, is a common problem in clinical practice. While there are clear guidelines concerning management of symptomatic hyperuricemia in acute conditions such as gout, urolithiasis or acute urate nephropathy, less is known about their secondary prevention. Moreover, despite the ongoing debate on the role of UA in the pathogenesis of chronic kidney disease, hypertension, cardiovascular disease and heart failure, the management of asymptomatic hyperuricemia in patients with these chronic conditions is still mainly up to physicians' judgement. Individual considerations should always be taken into account when prescribing urate-lowering therapy. In this narrative review study, we attempt to present current trends concerning treatment of patients with either symptomatic or asymptomatic hyperuricemia in the light of the available knowledge on the role of hyperuricemia in the development of gout, renal, cardiovascular and other diseases.
Rheumatoid arthritis (RA) is a systemic connective tissue disease which develops in the course of an autoimmune inflammatory process triggered by environmental factors in a genetically predisposed person. One of the environmental factors is the diet. RA patients’ adherence to a healthy diet remains low, despite plentiful data confirming positive effects of some foods, e.g. fish rich in n-3 polyunsaturated fatty acids (PUFAs), as well as the negative influence of unhealthy eating patterns, such as high consumption of fats and sugars, on RA incidence, activity and treatment response. In this review, we present current knowledge on the role of diet in rheumatoid arthritis, including dietary factors’ preventive/promoting influence on RA development, as well as their impact on RA activity. We hope this article will aid and encourage clinicians to recommend a relevant dietary intervention to their RA patients.
A b s t r a c tBackground: Linseed oil has cardio-protective effects. However, its antihypertensive action has not yet been well characterised. Aim:The primary purpose of the study was to evaluate the effect of short-term dietary supplementation with linseed oil on blood pressure (BP) and lipid metabolism in patients with mild hypercholesterolaemia. The secondary aim was to assess the effect of linseed oil on nitric oxide pathway and selected serum trace metals.Methods: 150 volunteers: 43 men (49.9 ± 11.5 years) and 107 women (53.2 ± 10.3 years), diagnosed with mild hypercholesterolaemia, were assessed prospectively for BP and lipid levels, before and after lipid-lowering diet plus linseed oil supplementation at a dose of 15 mL daily for four weeks (study groups) or four-weekly lipid-lowering diet (control group). Multivariate logistic regression analysis was used to determine the effect of linseed oil on BP after adjustment for age, sex, height, body weight, body mass index, smoking status, and alcohol consumption.Results: Supplementation with linseed oil significantly decreased low-density lipoprotein (LDL)-and non-high-density lipoprotein (HDL) cholesterol, and increased HDL-and HDL 3 -cholesterol levels. Additionally, linseed oil decreased diastolic BP in men (95% confidence interval [CI]: -6.0 to -1.1, p < 0.006), whereas in women linseed oil reduced (p < 0.001) systolic BP (-3.6 mmHg; 95% CI: -5.8 to -1.5) as well as diastolic BP (-4 mmHg; 95% CI: -5.8 to -2.1). Women with higher BP displayed an increase in serum L-arginine level (p < 0.01). In the logistic regression model oil consumption was associated with a decrease in mean BP (adjusted odds ratio 3.85; 95% CI 1.32-11.33). Conclusions:Our findings confirm the benefit of short-term linseed oil use in mild hypercholesterolaemia, particularly in patients with increased blood pressure.
Interstitial lung disease (ILD) is a group of lung diseases characterized by thickening of the interstitium surrounding pulmonary alveolar walls. It is related to specific radiographic features in lung imaging and/or the presence of restrictive disorders in pulmonary function tests (PFTs). ILD is one of the leading causes of death in systemic sclerosis patients. Major risk factors of ILD associated with SSc (SSc-ILD) include male sex, diffuse type of cutaneous SSc and presence of anti-Scl-70 antibodies.SSc-ILD is challenging to diagnose at an early stage as the symptoms are non-specific. The greatest risk of its development is during the 4–5 years after the initial diagnosis of systemic sclerosis. Clinical vigilance at the time, including regular pulmonary function tests and/or high-resolution com-puted tomography (HRCT), is needed. The aim of this paper is to summarize the current knowledge on early diagnostic methods and progression risk factors for SSc-ILD.
Methotrexate (MTX) is recommended as a first-line treatment for rheumatoid arthritis (RA). There are no strict guidelines regarding monitoring for liver damage in RA patients. This study aimed to evaluate noninvasive diagnostic procedures in assessing liver fibrosis in RA patients. Ninety-six RA patients were recruited for this study. The procollagen III N-terminal peptide (PIIINP) serum level was measured in all patients. The Enhanced Liver Fibrosis score (ELF-1) was calculated for 82 patients. Transient elastography (TE) was performed in 91 patients, those examined were divided into two groups: a study and control group, comprising patients with and without risk factors for liver fibrosis, respectively. The TE result correlated only with the body mass index—BMI (p < 0.05); there was no correlation with the cumulative MTX dose (p = 0.33). The TE result was significantly higher in those with risk factors for liver fibrosis than in those without risk factors (TE result > = 7.1 kPa 28/42 vs 13/41, HR = 2.103, Mann–Whitney U test, approximately 0.02). There was a positive correlation between the PIIINP level and body weight (p = 0.028), cumulative MTX dose (p = 0.007), RA activity (p = 0.028) and diabetes mellitus (DM) (p = 0.001). There was a positive correlation between the ELF-1 score and age (p < 0.001), cumulative MTX dose (p = 0.007) and RA activity (p < 0.001). The PIIINP level and ELF-1 score are not organ specific, and readings may vary depending on RA activity. TE is organ specific and can be performed by a skilled ultrasonographer might be useful to assess actual liver condition.
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