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BACKGROUND: Gout is associated with a high incidence of type 2 diabetes mellitus (T2DM).AIM: To calculate the risk of T2DM on the FINDRISС scale, to assess the sensitivity and specificity of the scale in patients with gout based on the results of prospective follow-up.MATERIALS AND METHODS: A prospective single-center study included 444 patients with gout over 18 years of age (49 women, 395 men) without diabetes. The duration of follow-up ranged from 2 to 8 years. Initially, the risk of developing diabetes mellitus 2 was calculated according to the Russian version of the FINDRISС scale. The risk of developing T2DM was assessed as «low» with a total score (CC) <7 points, slightly increased — from 7 to 11 points, moderate — from 12 to 14 points, high — from 15 to 20 points, and very high — ≥20 points. To assess the validity of using the FINDRISС scale, an analysis of sensitivity, specificity, construction of the ROC curve with the determination of the area under the curve was carried out. The presence and number of subcutaneous tophi, the number of arthritis attacks over the last year, the number of affected joints during the illness, serum levels of creatinine, uric acid, hs-CRP, glycated hemoglobin were determined.RESULTS: Over 5.66 [2.69; 7.64] years of follow-up, T2DM developed in 108 patients (24.3%). On the FINDRISС scale, low risk was found in 16 (4%), slightly increased in 187 (42%), moderate in 98 (22%), high in 80 (18%), very high in 63 (14%). The most common risk factors (RF) for T2DM included in FINDRISС were BMI> 25 kg / m2 — 85.6% of patients, taking antihypertensive drugs — 81.3% of patients, age over 45 years in 70.5% of patients. The sensitivity and specificity of the FINDRISС scale were 52.8% and 66.3%, respectively. According to these data, the quality of the model was assessed as moderate. 9% vs 31.1% (p = 0.014)), serum MK level ≤300 μmol / L. Developed type 2 diabetes 33.3% of patients with moderate / high / very high risk 18.1% of patients with low or slightly increased risk (p = 0.0002).CONCLUSION: The FINDRISС scale can have sufficient sensitivity (52.8%) and specificity (66.3%) and can be used to calculate the risk of T2DM in patients with gout.
BACKGROUND: Gout is associated with a high incidence of type 2 diabetes mellitus (T2DM).AIM: To calculate the risk of T2DM on the FINDRISС scale, to assess the sensitivity and specificity of the scale in patients with gout based on the results of prospective follow-up.MATERIALS AND METHODS: A prospective single-center study included 444 patients with gout over 18 years of age (49 women, 395 men) without diabetes. The duration of follow-up ranged from 2 to 8 years. Initially, the risk of developing diabetes mellitus 2 was calculated according to the Russian version of the FINDRISС scale. The risk of developing T2DM was assessed as «low» with a total score (CC) <7 points, slightly increased — from 7 to 11 points, moderate — from 12 to 14 points, high — from 15 to 20 points, and very high — ≥20 points. To assess the validity of using the FINDRISС scale, an analysis of sensitivity, specificity, construction of the ROC curve with the determination of the area under the curve was carried out. The presence and number of subcutaneous tophi, the number of arthritis attacks over the last year, the number of affected joints during the illness, serum levels of creatinine, uric acid, hs-CRP, glycated hemoglobin were determined.RESULTS: Over 5.66 [2.69; 7.64] years of follow-up, T2DM developed in 108 patients (24.3%). On the FINDRISС scale, low risk was found in 16 (4%), slightly increased in 187 (42%), moderate in 98 (22%), high in 80 (18%), very high in 63 (14%). The most common risk factors (RF) for T2DM included in FINDRISС were BMI> 25 kg / m2 — 85.6% of patients, taking antihypertensive drugs — 81.3% of patients, age over 45 years in 70.5% of patients. The sensitivity and specificity of the FINDRISС scale were 52.8% and 66.3%, respectively. According to these data, the quality of the model was assessed as moderate. 9% vs 31.1% (p = 0.014)), serum MK level ≤300 μmol / L. Developed type 2 diabetes 33.3% of patients with moderate / high / very high risk 18.1% of patients with low or slightly increased risk (p = 0.0002).CONCLUSION: The FINDRISС scale can have sufficient sensitivity (52.8%) and specificity (66.3%) and can be used to calculate the risk of T2DM in patients with gout.
Objective: to estimate the incidence of diabetes mellitus (DM) in patients with rheumatoid arthritis (RA) in the Republic of Karelia and to analyze the types of carbohydrate metabolism disorders.Patients and methods. The investigation enrolled 889 patients aged 18 years and older with RA treated in the Rheumatology Department, V.A. Baranov Republican Hospital (Petrozavodsk), in 2000 to 2019. Among them, there were 709 (79.8%) women and 180 (20.2%) men; the median age was 59 [52; 66] years; the median duration of RA was 6.5 [1.75; 13] years. Most patients were found to have positive rheumatoid factor (68.3%), the second and more advanced radiological stages (90.6%), and moderate and high RA disease activity (84.8%). Methotrexate as a mainstay disease-modifying anti-rheumatic drug was taken by 68.2%; biological agents and glucocorticoids (GCs) were used in 4.8 and 3.3%, respectively. The incidence of DM and its types and risk factors (RFs) were analyzed.Results and discussion. DM was recorded in 67 (7.5%) RA patients (55 women and 12 men; the median age was 62 [56; 66] years). Among these patients, 9 (1.0%) patients with RA were observed to have type 1 DM, 50 (5.6%) and 8 (0.9%) patients had steroid-induced DM (SIDM), and type 2 DM, respectively. In 55.5% of cases, type 1 DM was represented by latent autoimmune diabetes in adults (LADA), which is of late onset. SIDM was detected in 75% of patients over 60 years of age who had RFs for type 2 DM. In this study, the incidence of type 2 DM in RA patients exceeded official figures in the general population of the Russian Federation, but was close to the predicted prevalence rates of type 2 DM. Patients with RA and type 2 DM had major RFs, such as age over 45 years, hypertension, overweight or obesity; moreover, 60% of patients were found to have a combination of these factors.Conclusion. RA patients showed a higher incidence rate of carbohydrate disorders of different types; the number of cases of type 1 DM and type 2 DM among the examined patients with RA exceeded that in the regional DM registries in the general population in the Republic of Karelia. It seems advisable to screen for carbohydrate disorders in patients with RA, especially in the presence of RFs for type 2 DM and during systemic therapy with GCs.
Aim. To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism. Materials and methods. The study included 149 patients (125 women, 24 men) with RA (median age – 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity – AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded. Results. Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone – in 30.8 and 44.7%, according to FINDRISC – in 0 and 2.4%, respectively (p0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462–7.607; p=0.63). Conclusion. It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.
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