The Prevalence of Metabolic Syndrome in Patients with Gout: A Multicenter Study

Abstract

It has been suggested that hyperuricemia and possibly gout are associated with the metabolic syndrome, but there have been no direct studies. This study was undertaken to obtain the prevalence of the metabolic syndrome in patients with gout and to compare it with those from the general population studies. This was a 4-institutional case-historical control study composed of 168 patients with gout. We assessed the prevalence of metabolic syndrome according to the ATP III criteria and compared the prevalence with that of the historical controls. To elucidate the factors in gout that were associated with metabolic syndrome, a multivariate analysis was done. The age-adjusted prevalence of metabolic syndrome in gout patients was 43.6%, which was significantly higher than that of the Korean control population (5.2%) from the previous studies. Patients with gout had more components of metabolic syndrome than did the controls. Body mass index (BMI, OR=1.357 (95%CI 1.111-1.657)) and high density lipoprotein (HDL, OR=0.774 (95%CI 0.705-0.850)) were the variables most significantly associated with the occurrence of metabolic syndrome in gout, but alcohol consumption did not show such associations. Gout is associated with the metabolic syndrome, and furthermore, obesity and dyslipidemia were the factors most associated with the syndrome in these patients.

Prevalence of the metabolic syndrome in patients with gout: The Third National Health and Nutrition Examination Survey

“…In fact, the prevalence is substantially higher than among those who experienced myocardial infarction or stroke (41-44%) in the same NHANES study (18). These data expand on previous studies that demonstrated a close relationship between hyperuricemia and insulin resistance syndrome (6,9,10), and on the recent case series of gout and metabolic syndrome (12,13), thereby supporting a pathogenetic overlap between these conditions. Higher insulin levels are known to reduce renal excretion of urate (11,19 -21).…”

“…Therefore, the reduced renal excretion of urate among patients with metabolic syndrome may explain the increased frequency of hyperuricemia. Furthermore, recent case series reported that the prevalence of metabolic syndrome was high among patients with gout (82% in Mexican men [12] and 44% in Korean men [13] compared with 5% in the Korean general population [14]). Although these hospital-based case series (12,13) may have included patients who are sicker than individuals from the general population, the totality of available information points toward a strong link between gout and metabolic syndrome.…”

“…Furthermore, recent case series reported that the prevalence of metabolic syndrome was high among patients with gout (82% in Mexican men [12] and 44% in Korean men [13] compared with 5% in the Korean general population [14]). Although these hospital-based case series (12,13) may have included patients who are sicker than individuals from the general population, the totality of available information points toward a strong link between gout and metabolic syndrome. Because the serious implications of metabolic syndrome for overall health of individuals with gout are substantial, we determined the prevalence of the syndrome among patients with gout and examined the association between the 2 conditions based on the Third National Health and Nutrition Examination Survey (NHANES-III).…”

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

“…The stage of fibrosis was scored using a 6-point scale: 1a, mild zone 3 perisinusoidal fibrosis; 1b, moderate zone 3 perisinusoidal fibrosis; 1c, portal fibrosis only; 2, zone 3 and portal/periportal fibrosis; 3, bridging fibrosis; 4, cirrhosis. In addition to determining the NAFLD activity score (NAS), an overall diagnostic categorization was determined for each case as simple steatosis (NAS, 0-2), indefinite NASH (NAS, 3-4), and NASH (NAS, [5][6][7][8]. According to the fibrosis stage, cases were divided into non-advanced fibrosis (stage of fibrosis, 0-2) and advanced fibrosis.…”

“…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.…”