Visceral fat obesity is highly associated with primary gout in a metabolically obese but normal weighted population: a case control study

Abstract

IntroductionGout is a chronic inflammatory disease the development of which is associated with obesity-induced metabolic abnormalities. However, a substantial number of non-obese patients (body mass index [BMI] <25 kg/m2) also develop gout in Korea. It was suggested that accumulation of visceral fat rather than subcutaneous fat is associated with metabolic abnormalities and hyperuricemia in patients with gout; therefore, we hypothesized that visceral fat accumulation was increased in non-obese gout patients.MethodsOne hundred and three male patients with primary gout and 204 age-matched healthy controls who attended a health check-up examination were recruited after the review of medical charts. The visceral fat area (VFA) was measured using the bioelectrical impedance analysis (BIA) method, and a VFA >100 cm2 was defined as visceral fat obesity (VFO). The frequency of VFO was compared in patients and control groups. The frequencies of metabolic syndrome and related parameters were also investigated.ResultsBMI, waist circumference, total fat mass, serum triglycerides, and serum glucose levels were significantly greater in patients compared with controls. VFA and the prevalence of VFO was increased in gout patients compared with controls. There were positive correlations between VFA and serum triglyceride levels and serum glucose levels. Multivariate regression analysis revealed that VFO is an independent risk factor for gout (odds ratio 2.488, 95% confidence interval 1.041–4.435). In non-obese subgroup analyses (gout patients, n = 38; healthy controls, n = 150), VFA (98.7 ± 19.3 vs. 91.0 ± 16.7, P = 0.016) and the frequency of VFO (47.4 vs. 27.3%, P = 0.017) remained significantly higher in gout patients. There was no difference in either BMI or total fat mass between patients and controls in the non-obese subgroup. The prevalence of metabolic syndrome in patients with gout was 31.7% (33/104), compared with 13.2% (5/38) in the non-obese subgroup according to modified ATP III criteria.ConclusionVFO, measured using BIA, is observed more frequently in patients with primary gout compared with healthy controls, even in non-obese individuals. Therefore, VFO might more properly represent metabolic derangements in patients with gout than general obesity.

Overfat and Underfat: New Terms and Definitions Long Overdue

“…A study of 926 retired NFL players whose mean BMI was 30 and mean waist circumference was 40 showed that 61% were at risk for atherosclerosis; the most at risk being those with larger waist circumference (10). A number of other studies have reported various discrepancies between BMI and the accumulation of body fat in various other populations (10, 35–37). Clearly, BMI has limited relevance for assessing accurate markers of body composition and body fat distribution, which are important signs of metabolic health (1).…”

Influence of obesity on serum uric acid level in postmenopausal women

“…Mogući razlog za takav nalaz je mala veličina uzorka. Nepostojanje povezanosti između sMK i lipida potvrdili su i neki drugi autori [9].…”

“…Kao dodatak svemu navedenom, istraživanja pokazuju [9] da je i kod normalno uhranjenih osoba (ITM<25kg/m2), prevalenca visceralne gojaznosti bila veća kod pacijenata sa gihtom, nego kod kontrolne grupe, uprkos nepostojanju razlike u ukupnom sadržaju masti između ove dve grupe ispitanika, sugerišući da visceralna gojaznost, nezavisno od generalizovane gojaznosti, doprinosi hiperurikemiji i patogenezi gihta.…”

“…Mada mehanizam putem kojeg povećane vrednosti MK dovode do oboljenja posredovanih gojaznošću nije u potpunosti razjašnjen, pretpostavlja se da je pokretanje intracelularnog oksidativnog stresa i inflamacije u hipertrofičnom i hiperplastičnom masnom tkivu ključni faktor nastanka poremećaja niza signalnih puteva i, posledično, brojnih oboljenja [9].…”

Foot-related pain and disability and spatiotemporal parameters of gait during self-selected and fast walking speeds in people with gout: A two-arm cross sectional study

“…Gout is a complex disease associated with several comorbidities, including obesity [11], which has been shown to influence walking patterns in individuals without gout [12,13]. However, it is currently unclear whether excess body mass contributes to the altered gait patterns observed in individuals with gout as control participants in previous research have also had elevated body mass [8].…”