AB0638 CYTOKINE STATUS IN METABOLIC SYNDROME IN PATIENTS WITH GOUTY ARTHRITIS
Authors: K. Zhigulina, S. Spitsina
Journal: Annals of the Rheumatic Diseases (2021)

<h3>Background:</h3> Gout is an inflammatory and metabolic disease. Hyperuricemia can contribute to inflammation, hypertension and cardiovascular disease, adipogenesis and lipogenesis, impaired insulin and glucose metabolism, and the development of liver disease. In turn, non-alcoholic fatty liver disease is the most common chronic liver disease worldwide; is closely related to obesity, type 2 diabetes mellitus, dyslipidemia and other metabolic risk factors included in metabolic syndrome (MS). Interest in the problem of MS has not faded for many years, which is associated with its extremely rapid spread in the world. <h3>Objectives:</h3> To assess the cytokine status in patients with gouty arthritis (GA) in combination with metabolic syndrome (MS). <h3>Methods:</h3> There were 60 patients with reliable GA under observation. Among the surveyed men and women accounted for 60% and 40%, respectively, with an average age of 54 years, an average duration of the disease of 8 years. A family history of gout was present in 42% of patients. The onset of gouty arthritis was observed at 35.6 ± 10 years. Hypouricemic therapy was prescribed in 70% of patients. Thirty-six patients were diagnosed with the tofus form, 24 had no tofus. Patients were included in the study during arthritis remission. Blood samples were taken for general clinical and biochemical analyzes (ESR according to Westergren and uric acid levels were estimated), as well as for determination of serum concentrations of TNF-alpha and IL-6 by enzyme immunoassay. <h3>Results:</h3> The patients were divided into two groups: group 1 - 40 people with GA without signs of MS, group 2 - 20 patients with GA and MS. Patient groups were matched by sex, age, form and severity of the disease. In the 1st group, the body mass index ranged from 28.00 to 34.25 kg / m2, in the 2nd group - from 29.05 to 49.39 kg / m2. In patients with isolated gout, the waist in men averaged 96 cm, in women - 86.5 cm; in the 2nd group: in men - 98 cm, in women - 88 cm. Among the criteria for MS, in addition to abdominal obesity, in the 2nd group, arterial hypertension (in 64%), dyslipidemia (mainly types IIa and IIb) were significantly more frequent, violation of carbohydrate metabolism (fasting glycemic level 8.0 + 2.0 mmol / l), a higher level of uricemia (from 397.8 to 660.5 mmol / l) compared with the 1st group. The average level of IL-6 in the serum of patients in group 1 was 1.46 pg / ml, in group 2 - 14.03 pg / ml, the average level of TNF-alpha in group 1 was 0.51 pg / ml, in group 2 - 1.28 pg / ml. <h3>Conclusion:</h3> In GA patients with signs of MS, there is a significant increase in the production of key proinflammatory cytokines, namely IL-6, TNF-alpha. It was found that with a combination of MS and GA, the concentrations of IL-6, on average, 9.6 times, and TNF-alpha - 2.5 times, exceed the parameters of patients without signs of MS. A direct relationship was established between the expression of IL-6 and TNF-alpha with body mass index, as well as with insulin resistance and fluctuations in blood pressure. Thus, the cytokine imbalance is associated with increased risks of both cardiometabolic complications and the progressive course of GA. <h3>Disclosure of Interests:</h3> None declared.