AB0928 DISORDERS OF FATTY ACID METABOLISM IN THE FORMATION OF ARTERIAL HYPERTENSION IN PATIENTS WITH GOUT
Authors: M. Gromova, V. Tsurko, O. Kisliak, E. Kiseleva
Journal: Annals of the Rheumatic Diseases (2020)

Background: One of the possible mechanisms of the formation of cardiovascular disorders in patients with gout may be a violation of the metabolism of fatty acids. Decrease of the total content of unsaturated fatty acids (UFAs) has a multifaceted adverse effect on a number of metabolic processes which lead to the development of arterial hypertension (AH) and atherosclerosis as a result. There are no studies on the level of UFAs in the blood of patients with gout depending on the presence of hypertension. Objectives: To study the level of UFAs in the blood of patients with gout depending on the presence of AH. Methods: We examined 87 patients with gout and AH. 83% were men (mean age 55.4 ± 12.3 years). All patients had chronic gouty arthritis, 30% of patients had tofus. The duration of gout was 8 [4; 11] years. AH was detected in 49 (56.2%) people. The duration of AH was 7 [2; 10] years. All patients went through standard general clinical, laboratory and instrumental examination. Ozonation method was developed and put into practice in N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Science (FRCCP RAS), to assess disorders of the lipid metabolism for diagnostic purposes. The essence of the method is to determine the level of unsaturation of serum or blood plasma lipids which depends on the total amount of double bonds (DB) in UFAs both in a free state and within lipid combination. This parameter is called the Double Bond Index (DBI). DBI is measured by a domestic device ADS-5M («Double bond analyzer») developed at FRCCP RAS. The control group consisted of 20 healthy men, comparable in age. Statistical analysis of the data was carried out using the STATISTICA 10.0 program. Results: Patients were divided into 2 groups: patients with gout with normal blood pressure (group 1; n = 38) and with AH (group 2; n = 49). Patients from group 2 differed by a longer course of gout and had a higher level of uric acid in comparison with patients from group 1. The number of joints involved in the inflammatory process in patients from group 2 exceeded the number of those in patients from group 1. Patients from group 2 had more often attacks of gouty arthritis and the severity of pain during the last year compared with group 1. The normative value of the blood serum lipids DBI was determined for the control group of healthy people (260 + 20 conventional units (c.u.)) by the ozonation method. A significant deviation of the DBI from the norm both increased and decreased is a sign of pathology. In all groups DBI is lower than the norm but to a different extent. DBI is slightly reduced relative to the norm (DB = 229 c.u.) in group 1 therefore lipid metabolism is impaired just slightly. DB = 167 c.u. in group 2 which indicates a significant disorder of lipid metabolism (p&lt;0,05). Thus the ozonation method is informative and allows to quantify the severity of patient general condition and DBI is an integral indicator of changes in the number of fatty acids and body general condition. Conclusion: The presence of AH in patients with gout makes the clinical course of the disease more severe and exacerbates lipid disorders that can make significant changes in the formation of cardiovascular complications in this category of patients. DBI can be used as an additional criteria in laboratory diagnostics and monitoring to develop adequate treatment tactics. Disclosure of Interests: Margarita Gromova Speakers bureau: Speaker for Biotehnos, Boehringer-ingelheim, Vladimir Tsurko Speakers bureau: Speaker for Boehringer-ingelheim, Berlin-chemie, Oksana Kisliak Speakers bureau: Speaker for Berlin-chemie, KRKA, Elena Kiseleva: None declared