Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis

Abstract

The study was performed to confirm the high prevalence of metabolic syndrome in gouty patients and to define the relationship between insulin resistance and gouty arthritis. We recruited 83 patients with gouty arthritis and checked clinical factors according to the diagnostic criteria of metabolic syndrome from the ATP III guidelines and WHO Asia-Pacific obesity criteria recommendations. We also assessed the clinical characteristics of subjects and homeostasis model assessment of insulin resistance (HOMA-IR) and compared with previous study groups as controls. The prevalence of metabolic syndrome in patients with gout was 30.1% according to ATP III criteria and 50.6% with WHO Asia-Pacific adjustment and is significantly higher than the previous control study groups (ATP III: 5.2, 10.6%, WHO Asia-Pacific adjustment: 9.8, 13.9%). The mean value of HOMA-IR in patients with gout was 2.63 ± 1.36 and is significantly higher than control study (1.91 ± 1.01, P < 0.05). There were significant correlations between 24-h urinary uric acid excretion and waist circumference (r(2) = 0.225, P = 0.049), fasting insulin (r(2) = 0.241, P = 0.035), and insulin resistance (HOMA-IR) (r(2) = 0.271, P = 0.017). There were significant correlations between insulin resistance and waist circumference (r(2) = 0.341, P < 0.01), BMI (r(2) = 0.390, P < 0.01). The value of HOMA-IR (insulin resistance) and the prevalence of metabolic syndrome in patients with gout are significantly higher than normal healthy control groups. The hyperuricemia in gout might be caused by the increased adiposity associated with insulin resistance.

Relationship of serum uric acid level with non‐alcoholic fatty liver disease and its inflammation progression in non‐obese adults

“…between SUA level and the inflammation progression of NAFLD is that increased SUA is also linked to increased fat accumulation, hyperleptinemia, and insulin resistance. 11,23 Uric acid becomes a strong oxidant in the environment of MetS. Serum uric acid could also stimulate the release of oxidants to promote oxidative stress by stimulating nicotinamide adenine dinucleotide phosphate oxidase and then be involved in the pathogenesis of NAFLD.…”

“…5 Although uric acid is recognized as an antioxidant, hyperuricemia has been implicated in the development of gout, coronary artery disease, type 2 diabetes, MetS, and NAFLD. [6][7][8][9] Increased SUA has been linked to increased oxidative stress, chronic low grade inflammation, and insulin resistance, 10,11 which are the basic pathophysiology of NAFLD.…”

The Rate of Metabolic Syndrome and Comorbidities in Patients With Gout: Data of a Multicenter Trial

“…[8,[16][17][18][19][20]. Однако частота выяв-ления отдельных заболеваний в разных группах больных по-дагрой может существенно различаться.…”

Interrelationship of Uric Acid, Gout, and Metabolic Syndrome: Focus on Hypertension, Cardiovascular Disease, and Insulin Resistance

“…Similarly, in the Korean population over 20 years old, Lim et al [22] demonstrated that the prevalence of metabolic syndrome gradually increased from 24.9% in 1998 to 31.3% in 2007. Several clinical investigations showed a higher prevalence of metabolic syndrome in patients with gout compared to the general population [12,13,23]. The prevalence of metabolic syndrome in Korean patients with gouty arthritis was 30%∼ 42% according to NCEP ATP III guidelines and 50%∼ 59% according to the WHO Asia-Pacific obesity criteria, both of which were significantly higher than the normal control groups [13,23].…”

“…There is growing evidence that there is close association between uric acid and metabolic syndrome [9][10][11]. In addition, the prevalence of metabolic syndrome in patients with gout is higher than in control groups [12,13]. Here, this paper reviews the complex interrelationship between hyperuricemia/gout and metabolic syndrome as well as its components including hy- …”