BackgroundThe association of metabolic status with disease characteristics of rheumatoid arthritis (RA) remain controversial. Body composition (BC) instead of body mass index (BMI) has been more and more recommended to assess metabolic status.ObjectivesTo investigate the characteristics of BC in RA patients and their association with RA disease characteristics.MethodsBC was assessed in RA patients and control subjects by bioelectric impedance analysis. Overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. Sarcopenia was defined by skeletal muscle mass index (SMMI)≤8.87 kg/m2 in men and ≤6.42 kg/m2 in women. Clinical data including disease activity, function and radiographic assessment were collected.ResultsThere were 457 RA patients and 1,860 control subjects recruited. In RA patients, there were 17.7%, 58.0%, 20.1% and 4.2% with underweight, normal weight, overweight, or obesity respectively, and 32.4% were overfat, 11.4% with sarcopenia. Comparisons to control subjects in age and gender stratification showed that male RA patients had significantly lower BMI and SMMI with higher percentage of underweight and sarcopenia in almost all age subgroups; female patients had lower SMMI in all age subgroups and lower BMI with higher prevalence of sarcopenia but higher BF% at age ≤30 and 51–60 years (all P<0.05, figure 1). RA patients with sarcopenia had higher rate of functional limitation, higher disease activity indicators and radiographic scores (all P<0.05, table 1). Multivariate logistic regression analyses showed SMMI (OR=0.633, 95%CI: 0.507~0.790, P<0.001) and sarcopenia (OR=2.154, 95%CI: 1.032~4.497, P=0.041) were associated with radiographic joint damage.CharacteristicsBF%SMMINormal fat (n=309)Overfat (n=148)P Non-sarcopenia (n=405)Sarcopenia (n=52)P Female, n (%)253 (81.9)125 (84.5)0.494353 (87.2)25 (48.1)<0.001Age, yrs, median (IQR)49 (37~58)54 (48~61)<0.00150 (41~58)57 (27~63)0.397Disease duration, month, median (IQR)48 (24~96)64 (27~141)0.00552 (24~108)66 (24~129)0.382Positive RF, n (%)203 (65.7)97 (65.5)0.974259 (64.0)41 (78.8)0.033Positive ACPA, n (%)212 (68.6)105 (70.9)0.612283 (69.9)34 (65.4)0.508Core disease activity indicators28TJC, median (IQR)2 (0~5)2 (0~8)0.1452 (0~5)4 (0~9)0.09128SJC, median (IQR)1 (0~4)1 (0~4)0.2481 (0~4)2 (0~8)0.200ESR, (mm/h), median (IQR)26 (15~44)32 (15~52)0.13326 (14~45)42 (26~74)<0.001CRP, (mg/L), median (IQR)3.8 (3.3~12.9)5.4 (3.3~20.0)0.0083.8 (3.3~12.4)15.5 (5.2~32.8)<0.001DAS28-CRP, median (IQR)3.2 (2.0~4.1)3.4 (2.3~4.8)0.0433.1 (2.0~4.2)4.0 (2.6~5.5)0.003HAQ-DI, median (IQR)0.13 (0~0.50)0.38 (0~1.00)<0.0010.13 (0~0.63)0.50 (0.03~1.25)0.002Functional limitation, n (%)38 (12.3)32 (21.6)0.01053 (13.1)17 (32.7)<0.001Radiographic assessmentmTSS, median (IQR)11.0 (3.8~32.5)16.5 (6.6~50.8)0.00512.0 (4.0~32.5)24.0 (10.0~79.8)0.001JSN subscore, median (IQR)3.0 (0~11.8)3.0 (0~20.0)0.1582.5 (0~12.3)9.0 (1.1~34.1)0.001Erosion subscore, median (IQR)9.0 (2.5~21.0)11.8 (6.0~29.8)0.0019.5 (3.0~21.0)19.0 (6.1~47.6)0.002RJD, n (%)168 (54.4)95 (64.2)0.047225 ...
BackgroundThe development of gout is associated with obesity and metabolic syndrome (MS). Obesity is defined by body mass index (BMI). However, BMI has being challenged for the limitation of not distinguishing different comprising tissues of the body. Body composition (BC) has been frequently recommended to assess metabolic status and will eventually replace BMI as a more reliable measure.ObjectivesTo investigate the characteristics of BC in gout patients and their significance with disease characteristics.MethodsBC was assessed in 180 consecutive gout patients and1,860 control subjects (white-collar employees in Zhangjiang InnoPark of Shanghai) by bioelectric impedance analysis. Overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. Demographic and clinical data as well as comorbid diseases were collected simultaneously. For the significant differences in the proportion of gender and age between two groups, the age- and gender-matched control subjects were randomly selected with the ratio of 1:1 for further statistics.Results(1)Among 180 gout patients recruited, the mean age was 42.5±15.5 years, mean serum uric acid (sUA) was 9.0±2.4 mg/dl and 17.2% of patients presented tophi. The mean BMI was 25.4±3.5 kg/m2 with 44.4% overweight and 25.6% obesity. The mean BF was 26.2%±6.6% with 50.5% overfat. (2)Compared with control subjects, gout patients were characterised by higher BMI (25.4±3.5 kg/m2 vs. 24.3±3.3 kg/m2), fat mass (19.3±6.9 kg vs. 16.5±6.2 kg), trunk fat mass (10.2±5.4 kg vs. 8.4±3.4 kg), BF (26.2%±6.6% vs. 22.4±6.2%), proportion of overfat (50.5% vs. 27.2%), but lower lean mass (53.0±7.7 kg vs. 55.6±7.7 kg, all p<0.05). (3)Compared with normal fat patients (n=89), gout patients with overfat (n=91) presented higher duration of gout, the count of affected joints, flare times in the past year, family history and presence of tophi (all p<0.05, table 1). Overfat gout patients also exhibited higher BMI, more obesity, hyper-low density lipoproteinemia, MS and fatty liver (all p<0.05). (4)There were 9 (17.3%) overfat gout patients in 53 normal weight patients who presented more hypercholesterolemia (55.6% vs. 13.3%), hyper-low density lipoproteinemia (55.6% vs. 17.8%) and fatty liver (77.8% vs. 35.6%) and less skeletal muscle mass index (SMMI, 8.3±0.5 kg/m2 vs. 9.7±0.7 kg/m2) than those patients with normal fat and weight (all p<0.05). Meanwhile, there were 44 (34.9%) gout patients with normal fat among 126 overweight and obesity patients who had less MS (40.9% vs. 63.4%) and more SMMI (11.1±0.9 kg/m2 vs. 10.6±1.1 kg/m2) than overfat patients (both p<0.05). (5)Overfat was a risk factor for MS [OR 3.4 (1.8, 6.4), p<0.001] after adjusted by age and gender.Abstract AB1032 – Table 1Comparison of disease characteristics between gout patients in BF subgroupsBMI: body mass index; SMMI: skeletal muscle mass indexConclusionsOur results indicated higher body fat in gout patients which is an independent risk factor for MS.AcknowledgementsThe present study was supported by Guangdong Natural Scie...
Background The prevalence of urolithiasis in general Chinese population was 5%>10%. It has been reported as a common complication of gout in many countries (20%>39.5%) but not yet in China. Urolithiasis is one of the contraindications of uricosuric drugs. However, allopurinol, the only other available urate lowering drug in China, has been confirmed high risk of allopurinol hypersensitivity syndrome in Chinese population and those with chronic kidney disease. Objectives To investigate the prevalence of urolithiasis in southern Chinese gout patients and the possible risk factors. Methods 201 hospitalized patients with primary gout were recruited and their clinical data were collected. Current urolithiasis was defined as positive image finding including ultrasound, plain film or computer tomography. Positive history of urolithiasis delivery or urolithiasis surgery but negative image finding was defined as previous urolithiasis. Results (1)Among 201 gout patients, 89.1% were male with mean age 57.5±16.9 years while 10.9% were female with mean age 68.5±11.9 years. The mean disease duration was 7.9±7.4 years with involved joints 6.4±7.4. 30.7% patients presented tophi. The average serum uric acid (sUA) was 8.9±2.7mg/dl with 24h uric acid excretion 451.9±240mg. 91.6% patients excreted uric acid lower than 800mg/24h. Serum creatinine was 133.1±84.6umol/l and estimate glomerular filtration rate (eGFR) 60.0±19.4ml/min. (2) 33.8% patients complicated with urolithiasis, of which 75.0% were current urolithiasis and 33.8% were current urolithiasis without positive urolithiasis history. 84.3% were neprolithiasis and 57.1% were multiple urolithiasis. (3)Table 1 showed significant differences of sUA, hyperuricemia, eGFR, impaired renal function and renal cyst between urolithiasis group and non-urolithaisis group. Current urolithiasis exacerbate eGFR more than previous urolithiasis (51.4±18.3ml/min VS 61.8±17.8ml/min, P=0.045). (4) Urolithiasis was significantly correlated with hyperuricemia (r=0.156, P=0.027), impaired renal function (r=0.27, P<0.001) and renal cyst (r=-0.252, P<0.001). Logistic regression showed that renal cyst negatively predicted the presence of urolithiasis in gout patients (OR=0.066, 95%CI 0.013-0.298, P=0.001) while eGFR<60ml/min promoted urolithiasis (OR=3.786, 95%CI 1.516-9.454, P=0.004). Conclusions Our results showed high prevalence of urolithiasis in southern Chinese gout patients. Routine imaging test on urinary system should be performed to detected urolithiasis in all gout patients especially for those with renal impairment. Disclosure of Interest None Declared
BackgroundUrolithiasis greatly impact urate lowering therapy in Chinese gout patients. Benzbromarone is contraindicated and Chinese is high risk of allopurinol hypersensitivity syndrome. Febuxostat is too expensive for many patients. Few study about urolithiasis in Chinese gout patients are presented.ObjectivesTo investigate the prevalence and risk factors of urolithiasis in south Chinese gout patients.MethodsPatients with primary gout were recruited in the present cross-section study. Urolithiasis was defined as positive stone history and/or ultrasonography. All inpatients with estimated glomerular filtration rate (eGFR) over 30 ml/min/1.73 m2 underwent 24 hours urinary chemistry assay including uric acid (UA), UA concentration, clearance of UA, Cr, calcium, phosphorus, potassium, sodium and chloride. Logistic regression were performed to examine association of urolithiasis with independent variables including age, gender, duration of gout, sUA, previous urate lowering therapy, serum creatinine, eGFR, body mass index, urine pH and 24 hours urinary chemistry assay.Results(1) Two hundred and nighty-four patients were recruited. Mean age of male (N=255) and female (N=39) were 54.4±16.4 and 67.2±15.3, respectively. Average serum UA was 9.0±2.5mg/dl and 25.9% of patients presented tophi. Allopurinol, benzbromarone, or a combination of these two drugs had been prescribed in 97 patients (33.0%), 18 patients (6.1%) and 36 patients (12.2%), respectively. The rest 143 patients (48.6%) had not received urate lowering therapy before. (2) One hundred and eleven gout patients (37.8%) complicated with urolithiasis and urolithiasis was observed in 69 of them (62.1%) on ultrasonography. Compared with non urolithiasis group, urolithiasis group had significant higher serum creatinine (1.6±0.6 VS 1.3±0.3 mg/dl], lower eGFR (56.3±18.0 VS 64.1±18.4 ml/min/1.73m2) and higher alcohol overuse (38.7% VS 26.2%) (P<0.05). (3) Among 102 patients performed 24 hours urinary chemical assay, 45 patients complicated with urolithiasis. Urolithiasis group had significantly higher 24 hours urine UA concentration than non-urolithiasis group (30.4±13.1 VS 23.9±11.9 mg/dl, P=0.01). There were no significant difference of other variables between two groups. Prevalence of urolithiasis increased significantly across increasing quartiles of urinary UA concentration (P=0.012, Table 1). (4) Logistic regression suggested that risk factors of urolithiasis were urinary UA concentration grouped by quartile (P=0.05) and urinary calcium excretion [OR 1.26 (1.01, 1.57), P=0.04]. Urinary UA concentration over 24.4mg/dl was associated with increasing risk of urolithiasis (Table 1).Table 1.Prevalence of urolithiasis among quartiles of urinary UA concentrationQuartiles of urinary UA concentration (mg/dl)I (<17.6)II (17.6–24.3)III (24.4–34.9)IV (≥35.0)Median (mg/dl)12.820.830.042.5Prevalence*13.3% (6)22.2% (10)33.3% (15)31.1% (14)Adjusted OR#12.47 (0.66, 9.24)5.5 (1.50, 20.72)4.58 (1.24, 16.92)P#–0.180.010.02*Test for a linear trend P=0.012. #By logistic regression.Conc...
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