Time course of changes in the clinical manifestations of gout in men: Data of a 7-year retrospective follow-up

Ms, Eliseev; Vg, Barskova; Is, Denisov

doi:10.17116/terarkh201587510-15

Cited by 16 publications

(4 citation statements)

References 21 publications

(23 reference statements)

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“…Результаты завершившихся эпидемиологических и проспективных клинических исследований свидетельствуют о высокой распространенности сердечнососудистых нарушений среди пациентов с подагрой [1,2,15].…”

Section: Discussionunclassified

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Kushnarenko¹,

Александровна²,

Мишко³

et al. 2020

Russ J Cardiol

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Aim. To study the effect of ivabradine and bisoprolol on cardiac hemodynamics and diastolic remodeling in gout patients with coronary artery disease and hypertension and without left ventricular systolic dysfunction.Material and methods. The open randomized parallel clinical trial of 35 men with intercritical gout at the age of 41,4±3,3 years, with class II-III stable angina, hypertension and sinus rhythm without data suggestive of heart failure was performed. All patients included in the study were randomly divided into two groups: eighteen patients took bisoprolol at a dose of 2,5 to 10 mg/day, 17 subjects received bisoprolol 2,5 mg/day with ivabradine (Coraxan, SERVIER, France) 5 mg 2 times a day. Adjustment of the therapy was carried out every 2 weeks until the target heart rate (HR) was reached at 55-60 beats/min and then remained unchanged until 12 weeks of therapy. All patients underwent echocardiography, 24-hour Holter and central aortic blood pressure monitoring, and 3-minute cycle ergometer test with a power of 25, 50, 75 and 100 watts.Results. There was a comparable decrease in the maximum and minimum 24-hour average heart rates in patients receiving only bisoprolol and those taking bisoprolol+ivabradine. Patients taking bisoprolol+ivabradine had a decrease of central systolic and diastolic blood pressure (BP). Pulse pressure in the bisoprolol group increased by 17,7% (p=0,02), and when ivabradine was added, on the contrary, it decreased by 7,0% (p=0,04). Twelve-week therapy with beta-blockers and ivabradine was accompanied by an effective decrease in the pulse wave velocity in both groups (p<0,05). All gout patients did not have a decrease of systolic function and there was an improvement in diastolic remodeling with beta-blockers and ivabradine therapy.Conclusion. The results obtained indicate that the addition of ivabradine to bisoprolol leads to an effective decrease in heart rate, an improvement in arterial stiffness and exercise tolerance. Combination therapy with ivabradine is accompanied by an improvement in clinical outcomes using lower doses of bet-blockers, which requires further study and a double-blind controlled study.

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Section: Discussionunclassified

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Kushnarenko¹,

Александровна²,

Мишко³

et al. 2020

Russ J Cardiol

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“…Тем не менее ни одному из участников с исходным уровнем МК сыворотки выше целевого (>0,36 ммоль/л) не удалось достичь нормального значения [28]. По данным крупного 7-летного ретроспективного исследования, ни один из 18 пациентов с подагрой, длительно соблюдавших низкопуриновую диету без сопутствующего приема уратснижающих препаратов, не достиг целевого уровня МК сыворотки, хотя это и снижало риск приступов артрита, образования тофусов, сопутствующих заболеваний [42]. По данным H. Ellmann и соавт., коррекция образа жизни, включавшая соблюдение диеты 24 пациентами с нетяжелой подагрой на протяжении 18 месяцев, приводила к незначительному снижению сывороточного уровня МК (с 7,2±1,7 мг/дл до 6,7±1,7 мг/дл (т.е.…”

Section: влияние ожирения на развитие и клинические проявления подагрыunclassified

The effect of bariatric surgery on purine metabolism and gout

Panevin¹,

Елисеев²,

Shestakova³

2020

Obes. metabol.

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Gout is an auto-inflammatory tophaceous disease characterized by the deposition of crystals of monosodium urate and developing in connection with this inflammation in people with hyperuricemia (HU). Except to genetic factors, risk factors for the development of HU and gout are many modifiable factors, including metabolic syndrome and obesity, and their correction is the most important component of successful disease control. Obesity can change the clinical picture of gout, characterized by an earlier onset, a large number of affected joints. Weight loss helps reduce uric acid (UA) serum levels. Bariatric / metabolic surgery significantly reduces the incidence of comorbid obesity and mortality, and is by far the most effective way to combat obesity. In addition to improving health, an important goal of bariatric surgery is to improve the quality of life. Bariatric surgery can prevent the development of HU in subjects with an initially normal level of serum UA before surgery. The dynamics of the concentration of UA in serum can be a predictor of successful bariatric surgery and help in predicting the severity of postoperative weight loss. The decrease in body weight after bariatric surgery leads to a decrease in UA in the long-term postoperative period, however, there is a high frequency of acute gout attacks in the early postoperative period. Thus, bariatric surgery has a significant effect on HU and gout and can be an effective treatment for this disease.

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“…have shown that eating seafood and meat increases the risk of gout by 1.51 times and 1.41 times, respectively. However, low compliance with dietary control as a result of eating habits, as well as nutrient and flavor requirements, not only disables the reduction of the level of uric acid in the blood, but also further aggravates insulin resistance and gout 11,12 . Therefore, research on low‐purine food based on patients' eating habits has become an important direction of dietary control of gout.…”

Section: Introductionmentioning

confidence: 99%

Computer‐assisted in vitro reconstitution of purine degradation pathway to lower the purine content in food

et al. 2022

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BACKGROUND With the increasing prevalence of gout and its etiological hyperuricemia, dietary control of gout based on low‐purine food according to patients' eating habits is becoming a better choice compared to the existing drug treatment such as allopurinol with notorious side effects. Reconstructing the purine metabolic pathway in vitro to degrade purine substances in food into natural functional allantoin appears to be an innovative method for preparing nutritious and healthy food of low purine content. The present study reports a computer‐assisted in vitro reconstruction of four purinolytic enzymes metabolizing adenosine into allantoin to reduce purine content in food for personalized dietary control of hyperuricemia and gout. RESULTS Under the optimum reaction conditions of 40 °C and pH 7, 0.1 U of enzymes and 0.5 mmol L−1 adenosine determined by an orthogonal test design, 16 different enzyme complexes were experimentally tested. The tested enzyme composition and allantoin production values were used as input and output to build a three‐layer back propagation artificial neural network (BP‐ANN) model, which was further optimized by a genetic algorithm (GA). The optimum enzyme complex predicted by the GA‐BP‐ANN model produced 248.08±7.832 μmol L−1 allantoin, which was 19.9% higher than equimolar mixture of enzymes, and also more efficiently lowered purine contents in beer, as well as beef and yeast extracts. CONCLUSION This is the first in vitro reconstitution of complete purine metabolic pathway by combining ANN and GA technologies, with successful application with respect to lowering the purine content in food, indicating a promising application of computer‐assisted in vitro reconstitution of purinolytic pathway in low‐purine food to prevent hyperuricemia and gout. © 2022 Society of Chemical Industry.

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Time course of changes in the clinical manifestations of gout in men: Data of a 7-year retrospective follow-up

Cited by 16 publications

References 21 publications

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

The effect of bariatric surgery on purine metabolism and gout

Computer‐assisted in vitro reconstitution of purine degradation pathway to lower the purine content in food

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