Clinical characteristics of early- and late-onset gout

Zhang, Bingqing; Fang, Wei‐Gang; Zeng, Xuejun; Zhang, Yun; Ying, Ma; Feng, Sheng; Zhang, Xinlei

doi:10.1097/md.0000000000005425

Cited by 18 publications

(19 citation statements)

References 23 publications

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“…BMI was one of the variables most significantly associated with the occurrence of metabolic syndrome in HUC29–31 and the percentage of overweight in patients with HUC was increasing 10. Our results also find that patients with early-onset HUC also had a significantly higher BMI (OR 1.281) compared with the healthy people of the same age, which was in accordance with the previous researches 13 19. Obesity could result in an insulin resistant state and compensatory increase in insulin secretion 32.…”

Section: Discussionsupporting

confidence: 91%

“…Young people are different from the old, they have different lifestyles and hormone levels and the morbidity of complications are lower 16. Some researches tried to describe the pathogenesis and clinical features about early-onset gout and HUC 13 17–19. Yan and her colleagues observed that elevated levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL) were independent risk factors for HUC 20.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

et al. 2019

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ObjectiveTo investigate the clinical characteristics of patients with early-onset hyperuricaemia (HUC).MethodsA retrospective study using data from the Second Affiliated Hospital of Soochow University was conducted. 623 patients with HUC were divided into early-onset group and late-onset group. Another 201 healthy subjects ≤40 years old were regarded as control group. The data of physical measurements and biochemistry test were collected. Clinical data of early-onset group were compared with late-onset group and control group by analysis of variance (ANOVA) and χ2test. Principal component analysis (PCA) was applied. Logistic regression was used to identify the clinical factors correlated with patients with early-onset HUC.ResultsThe patients of early-onset group had different body mass index (BMI), serum albumin, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), gamma-glutamyltransferase (GGT), creatinine (Cr), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), TG/high density lipoprotein (HDL) ratio, HDL and percentage of males, hypertension (HBP) as well as fatty liver compared with healthy people in the control group. Early-onset group patients had different albumin, ALT, fasting blood glucose, Cr, percentage of males and HBP compared with late-onset group patients. PCA identified four significant patterns including PC1 (labelled ‘TG and HDL’), PC2 (labelled ‘fatty liver and liver enzymes’), PC3 (labelled ‘TC and LDL’) and PC4 (labelled ‘AKP’). The results of univariate and multivariate logistic regression analysis showed that BMI, HBP and albumin were correlative factors for early onset of HUC when the patients with early-onset and late-onset HUC were involved, while gender, BMI, PC1, PC2 and PC4 were correlative factors for early-onset HUC when the early-onset and control groups were involved.ConclusionThis study described a group of patients with early-onset HUC with distinct clinical features. Gender, BMI, ‘TG and HDL’, ‘fatty liver and liver enzymes’ and ‘AKP’ have higher values than HBP, type 2 diabetes mellitus and ‘TC and LDL’ in patients under 40 years old with early-onset HUC.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

et al. 2019

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“…Recent data suggest that the number of gout patients under the age of 40 years (early-onset) is increasing [ 4 ]. These early-onset patients may have different clinical signs and co-morbidities from those who present with gout at a later age [ 5 , 6 ]. Given the development of earlier metabolic disorders in the early-onset gout patients compared with common gout patients [ 5 ], together with the need for continuous management of health from their younger age, understanding the risks of early-onset gout is clinically important.…”

Section: Introductionmentioning

confidence: 99%

Identification of Two Dysfunctional Variants in the ABCG2 Urate Transporter Associated with Pediatric-Onset of Familial Hyperuricemia and Early-Onset Gout

Toyoda

Pavelcová

Bohatá

et al. 2021

IJMS

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The ABCG2 gene is a well-established hyperuricemia/gout risk locus encoding a urate transporter that plays a crucial role in renal and intestinal urate excretion. Hitherto, p.Q141K—a common variant of ABCG2 exhibiting approximately one half the cellular function compared to the wild-type—has been reportedly associated with early-onset gout in some populations. However, compared with adult-onset gout, little clinical information is available regarding the association of other uricemia-associated genetic variations with early-onset gout; the latent involvement of ABCG2 in the development of this disease requires further evidence. We describe a representative case of familial pediatric-onset hyperuricemia and early-onset gout associated with a dysfunctional ABCG2, i.e., a clinical history of three generations of one Czech family with biochemical and molecular genetic findings. Hyperuricemia was defined as serum uric acid (SUA) concentrations 420 μmol/L for men or 360 μmol/L for women and children under 15 years on two measurements, performed at least four weeks apart. The proband was a 12-year-old girl of Roma ethnicity, whose SUA concentrations were 397–405 µmol/L. Sequencing analyses focusing on the coding region of ABCG2 identified two rare mutations—c.393G>T (p.M131I) and c.706C>T (p.R236X). Segregation analysis revealed a plausible link between these mutations and hyperuricemia and the gout phenotype in family relatives. Functional studies revealed that p.M131I and p.R236X were functionally deficient and null, respectively. Our findings illustrate why genetic factors affecting ABCG2 function should be routinely considered in clinical practice as part of a hyperuricemia/gout diagnosis, especially in pediatric-onset patients with a strong family history.

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“…One recent study found that patients with early-onset gout were more likely to have polyarticular flares, higher serum uric acid levels, and higher rates of metabolic syndrome [ 8 ]. In a cross-sectional observational study, patients with onset of gout before the age of 40 years had more frequent flares, more joints clinically affected, and fewer cardiovascular, cerebrovascular, and renal comorbidities at presentation but were at higher risk of cardiovascular events [ 9 ]. Furthermore, a stratified analysis conducted as part of a meta-analysis of cohort studies revealed a gradual increase in the risk of myocardial infarction with younger age of gout onset [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

et al. 2021

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This study aimed to identify differences in clinical and dietary characteristics, serum adipokine levels, and metabolomic profiles between early- and late-onset gout. Eighty-three men with gout were divided into an early-onset group (n = 38, aged < 40 years) and a late-onset group (n = 45, aged ≥ 40 years). Dietary and clinical information was obtained at baseline. Serum adipokines, including adiponectin, resistin, leptin, and plasminogen activator inhibitor-1 (PAI-1), were quantified by a Luminex multiplex immunoassay. Metabolite expression levels in plasma were measured in 22 representative samples using metabolomics analysis based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Average body mass index, rate of consumption of sugar-sweetened beverages, and serum uric acid levels were significantly higher in the early-onset group (p < 0.05), as was the PAI-I concentration (105.01 ± 42.45 ng/mL vs. 83.76 ± 31.16 ng/mL, p = 0.013). Changes in levels of metabolites mostly involved those related to lipid metabolism. In the early-onset group, acylcarnitine analog and propylparaben levels were downregulated and negatively correlated with the PAI-1 concentration whereas LPC (22:6) and LPC (18:0) levels were upregulated and positively correlated with the PAI-1 concentration. Dietary and clinical features, serum adipokine concentrations, and metabolites differed according to whether the gout is early-onset or late-onset. The mechanisms of gout may differ between these groups and require different treatment approaches.

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Clinical characteristics of early- and late-onset gout

Abstract: Supplemental Digital Content is available in the text

Cited by 18 publications

References 23 publications

Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

Identification of Two Dysfunctional Variants in the ABCG2 Urate Transporter Associated with Pediatric-Onset of Familial Hyperuricemia and Early-Onset Gout

Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

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