Effects of febuxostat on insulin resistance and expression of high-sensitivity C-reactive protein in patients with primary gout

Abstract

We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Gout patients had higher levels of UA, INS, HOMA-IR, and hs-CRP than normal controls (P < 0.05). After 4-, 12-, and 24-week febuxostat treatments, UA and hs-CRP concentrations were significantly lower than baseline (P < 0.05). INS and HOM-IR decreased slightly after a 4-week treatment with febuxostat but declined significantly after 12 and 24 weeks of treatment. Importantly, hs-CRP values positively correlated with those of HOMA-IR (r = 0.353, P = 0.018) and INS (r = 0.426, P = 0.034). Our findings confirm that IR exists in gout patients and implicate that febuxostat can effectively control the level of serum UA and increase insulin sensitivity in primary gout patients.

Chicken or the Egg? Hyperuricemia, Insulin Resistance, and Hypertension

“…Reducing (serum and intracellular) uric acid concentrations has been shown to allay features of metabolic syndrome in experimental models. Febuxostat, a xanthine oxidase inhibitor, was associated with reduced insulin resistance in people with gout in a recent observational study [6].…”

Fructose and Uric Acid: Major Mediators of Cardiovascular Disease Risk Starting at Pediatric Age

“…This hypothesis might explain the conflicting results reported in studies investigating the use of urate- lowering treatments in adults with established hypertension or chronic renal disease. Thus, at variance with these data, small pilot studies conducted in children and adolescents showed a reduction in blood pressure [ 63 , 64 ] and improvement in insulin sensitivity [ 99 , 100 ] and CKD [ 101 ] with the use of urate-lowering treatments. We believe further studies are needed before definitive conclusions can be drawn regarding the reversibility of the mechanisms sustaining the relationship between fructose, uric acid and all the metabolic dysregulations.…”

Blood glucose fluctuations detected by continuous glucose monitoring system in gout patients with normal glucose tolerance and the effect of urate‐lowering therapy

“…Some studies also displayed an obvious relationship between uric acid and diabetes risk, and hyperuricemia or gout was associated with diabetes risk 5‐7 . In addition, many patients with hyperuricemia or gout have increased insulin resistance (IR) before the onset of diabetes, which is defined as a decline in the sensitivity of target organs or tissues to insulin and could play a critical role in the pathogenesis of diabetes 8,9 …”