Efficacy of uric acid‐lowering therapy on hypercholesterolemia and hypertriglyceridemia in gouty patients

Wu, Jing; Zhang, Yuping; Yuan, Qing; Jie, Ligang; Deng, Jiaxin; Q, Yu

doi:10.1111/1756-185x.13652

Cited by 15 publications

(14 citation statements)

References 23 publications

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“…It is consistent with a longitudinal study in China that found that the highest quartile of SUA had 45.6% of cumulative incidence to hypertriglyceridemia [31]. In this sense, Jing Wu et al showed that uric acid-lowering therapy effectively improved serum cholesterol and triglyceride levels up to 80 mg/dL [32]. is may be explained by early metabolic changes such as activation of mitochondrial NADPH oxidase and inhibition of AMPK and AKT2, which alter lipid metabolism, mainly triglycerides [9].…”

Section: Discussionsupporting

confidence: 81%

Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru

Galindo-Yllu

Rojas-Humpire

Toro-Huamanchumo

et al. 2021

Journal of Nutrition and Metabolism

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We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) and insulin resistance (IR) among health personnel from a public hospital in Peru in a cross-sectional study with data from the Plan for the Prevention and Surveillance of Communicable and Noncommunicable Diseases of Huaycán Hospital. MetS was defined according to Latin American Diabetes Association (ALAD) criteria and IR with surrogate IR markers, triglyceride-to-HDL-C ratio (TG/HDL-C), and triglyceride-to-glucose index (TyG). The association between SUA and MetS and IR was determined using Poisson regression models in a sample of 292 participants with an average age of 46.2 ± 10.6 years. The total prevalence of MetS was 38%, and the individuals with MetS presented mainly alterations in anthropometric parameters (obesity and body fat). Finally, the adjusted regression models showed that women with SUA in the highest tertile increased the prevalence of MetS (PR: 1.71, 95% CI: 1.07–2.74) compared to the lowest tertile of SUA in women, while SUA increased hypertriglyceridemia and IR (TG/HDL-C and TyG) in both sexes. We concluded that SUA is strongly associated with MetS in women, and SUA increases hypertriglyceridemia and IR in both sexes. On the contrary, more research is required regarding the female population.

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Section: Discussionsupporting

confidence: 81%

Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru

Galindo-Yllu

Rojas-Humpire

Toro-Huamanchumo

et al. 2021

Journal of Nutrition and Metabolism

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“…Differences in race and ethnicity and baseline BMI could explain the heterogeneity of the results. Moreover, effects of ULT on blood triglycerides and cholesterol have been inconclusive both in animal experiments and clinical studies [ 21 , 48 – 50 ]. Given the complexity of lipid metabolism, measuring triglycerides and cholesterol may not be able to capture subtle differences or the effect of ULT on specific classes of lipids.…”

Section: Discussionmentioning

confidence: 99%

“…Xanthine oxidase inhibitor (XOI) therapy, particularly by use of allopurinol and febuxostat, is the primary approach used to treat hyperuricemia and thereby lower body urate stores [ 18 ]. XOI has had favorable treatment effects on experimental small animal models of hypertension, renal disease progression, atherosclerosis, and NASH [ 16 , 19 , 20 ], though net effects of XOI-based urate-lowering therapy remain unclear in adult humans with these conditions [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Xanthine oxidase inhibitor urate-lowering therapy titration to target decreases serum free fatty acids in gout and suppresses lipolysis by adipocytes

et al. 2022

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Objective Linked metabolic and cardiovascular comorbidities are prevalent in hyperuricemia and gout. For mechanistic insight into impact on inflammatory processes and cardiometabolic risk factors of xanthine oxidase inhibitor urate-lowering therapy (ULT) titration to target, we performed a prospective study of gout serum metabolomes from a ULT trial. Methods Sera of gout patients meeting the 2015 ACR/EULAR gout classification criteria (n = 20) and with hyperuricemia were studied at time zero and weeks 12 and 24 of febuxostat or allopurinol dose titration ULT. Ultrahigh performance liquid chromatography-tandem mass spectroscopy acquired the serum spectra. Data were assessed using the Metabolon and Metaboloanalyst software. Lipolysis validation assays were done in febuxostat and/or colchicine-treated 3T3-L1 differentiated adipocytes. Results Serum urate decreased from time zero (8.21 ±1.139 SD) at weeks 12 (5.965 ± 1.734 SD) and 24 (5.655 ±1.763 SD). Top metabolites generated by changes in nucleotide and certain amino acid metabolism and polyamine pathways were enriched at 12 and 24 weeks ULT, respectively. Decreases in multiple fatty acid metabolites were observed at 24 weeks, linked with obesity. In cultured adipocytes, febuxostat significantly decreased while colchicine increased the lipolytic response to β-adrenergic-agonism or TNF. Conclusion Metabolomic profiles linked xanthine oxidase inhibitor-based ULT titration to target with reduced serum free fatty acids. In vitro validation studies revealed that febuxostat, but not colchicine, reduced lipolysis in cultured adipocytes. Since soluble urate, xanthine oxidase inhibitor treatment, and free fatty acids modulate inflammation, our findings suggest that by suppressing lipolysis, ULT could regulate inflammation in gout and comorbid metabolic and cardiovascular disease.

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“…This result can be explained by the fact that fasting glucose was positively correlated to SU when it is below the threshold (6.5 mmol/L in men and 7.5 mmol/L in women) ( 33 ). In addition, the indirect mechanism of insulin resistance may also be involved in the results ( 34 , 35 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Clinical Typing on Serum Urate Targets of Benzbromarone in Chinese Gout Patients: A Prospective Cohort Study

et al. 2022

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IntroductionAchieving a goal of serum urate levels in patients with gout is an important way to prevent gout and its complications while it remains difficult with a low targeting rate worldwidely. Currently, hyperuricemia classification has not been widely applied to the management of gout owing to insufficient clinical evidences. This study aimed to evaluate the effectiveness of achieving target urate based on hyperuricemia classification in Chinese patients with gout.MethodsIn this prospective study, patients with gout receiving urate lowering therapy with benzbromarone were assigned to two groups, a renal underexcretion and an unclassified type. The primary endpoint was the proportion of patients achieving the serum urate target (<360 μmol/L) during the 12-week study. The frequency of acute gout attacks as well as physical and chemical indicators were secondary endpoints.ResultsTarget serum urate level was achieved in 60.5% of underexcretors compared with 39.0% of patients of the unclassified type at week 12 (P = 0.002). Blood glucose and cholesterol levels were lower in the underexcretor group compared with the unclassified type group at the end of the trial, without significant different frequencies in gout flare during the study. In subgroup analysis, stratified by body mass index and estimated glomerular filtration rate, the proportion of patients with serum urate <360 μmol/L was greater in the underexcretion compared with the unclassified type group.ConclusionsThe increased achievement of target serum urate in the underexcretion group supports the use of a clinical hyperuricemia typing treatment strategy for gout.

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Efficacy of uric acid‐lowering therapy on hypercholesterolemia and hypertriglyceridemia in gouty patients

Cited by 15 publications

References 23 publications

Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru

Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru

Xanthine oxidase inhibitor urate-lowering therapy titration to target decreases serum free fatty acids in gout and suppresses lipolysis by adipocytes

Effect of Clinical Typing on Serum Urate Targets of Benzbromarone in Chinese Gout Patients: A Prospective Cohort Study

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