First Acute Gout Attacks Commonly Precede Features of the Metabolic Syndrome

Abstract

First attacks of gout may precede the diagnosis of metabolic abnormalities and associated diseases, and provids a unique opportunity to diagnose, prevent, and/or retard long-term complications in these patients.

Bileopancreatic Diversion with Duodenal Switch Lowers Both Early and Late Phases of Glucose, Insulin and Proinsulin Responses After Meal

“…Obesity, insulin resistance and dyslipidemia are the major factors associated with non-alcoholic fatty liver disease (NAFLD) [32,33], and ALT is a marker of non-alcoholic fatty liver ALT alanine aminotransferase, LDC-C low-density lipoprotein cholesterol, HDL-C highdensity lipoprotein cholesterol, TG triglycerides, f fasting, P plasma disease (NAFLD) and liver fat content which also reflects the glucometabolic status [34]. Uric acid is associated with obesity and insulin resistance [35], oxidative stress, endothelial damage, CVD and mortality [36,37]. Obesity has been implicated as a cause of both uric acid overproduction and poor renal clearance [38].…”

Insulin resistance and metabolic syndrome in primary gout: relation to punched‐out erosions

“…It is noteworthy to mention that the first attacks of gout may precede the diagnosis of metabolic abnormalities and associated diseases, and provides a unique opportunity to diagnose, prevent and/or retard longterm complications in these patients. 14 To our knowledge, this is the first study to describe the relation between the presence of MTP erosions and insulin resistance. This focuses on the importance of considering MetS in gout patients especially those with…”

“…It has been reported that those patients without MetS should be carefully considered for development of MetS later on. It is noteworthy to mention that the first attacks of gout may precede the diagnosis of metabolic abnormalities and associated diseases, and provides a unique opportunity to diagnose, prevent and/or retard long‐term complications in these patients …”

“…Increased prevalence of gout is potentially attributable to recent shifts in diet, lifestyle, medical care and increased longevity . In 90% of cases, the first attack of gout precedes the diagnosis of MetS and after years of developing gout, association with related features of MetS become more evident, including increased obesity, hypertension, dyslipidemia, IR and diabetes mellitus . The usual initial presentation of gout is with rapidly developing acute inflammatory monoarthritis, typically affecting the first metatarsophalangeal (MTP) joint.…”

Management of Hyperuricemia and Gout

“…Patients with gout in one study were all shown to manifest the metabolic syndrome, and 16 % had ischemic heart disease [ 913 ] . A recent review of the clinical status of patients with respect to their fi rst episode of gout and the diagnosis of the metabolic syndrome and its components and complications showed that 90 % of the fi rst attacks of gout preceded the diagnosis of the metabolic syndrome, its components, and its complications [ 1001 ] . At the time of the inclusion of gouty patients into this study (a mean of 13.7 years after the fi rst attack of gout), 93 % of these patients had at least one associated disorder.…”