AB1301-HPR COMORBIDITIES AND FACTORS INFLUENCING RECURRENT GOUT ATTACK IN PATIENTS WITH GOUT: A CROSS-SECTIONAL STUDY
Authors: Y. Jiang, Z. Liao, Y. Huang, J. Liang, Y. Xie, J. Wu, J. Gu
Journal: Annals of the Rheumatic Diseases (2020)

Background: Gout attack is characterized by painful arthritis, loss of function and reduced quality of life. Frequent gout attacks can exert negative an influence on gout management [1]. Objectives: The objective was to identify the comorbidities of gout, to compare gender difference and to identify independent factors of multiple gout attacks. Methods: A cross-sectional study was performed to collect demographic, clinical variables, self-reported comorbidities, and relevant testing. Group comparison and correlation of serum uric acid (sUA) levels with other variables was performed. Univariate and multivariate logistic regression was used to detect independent risk factors of sUA. Results: 653 gout patients were enrolled, including 553 (84.7%) males. The mean age was 48.3±15.8 years old, with a disease duration of 8.0±6.4 years. 170 (26.0%) patients had hypertension, and 57 (8.7%) had hyperlipidemia. Elevated total cholesterol (TC) was observed in 173 (26.5%) cases. 42 (37.1%) cases presented with increased triglycerides (TG) and 270 (41.3%) had increased low-density lipoprotein (LDL-C). Abnormalities including nephrolithiasis (29.4%), hydronephrosis (3.2%), and gallstones (11.9%) were detected in the patients who underwent ultrasound examination. Although female patients had a longer disease duration, they had lower levels of sUA, creatine and C-reactive protein (CRP). A positive correlation with sUA was found in TG and CRP ( P &lt;0.05) in female patients, which was not observed in males. Only gout duration (OR=1.406, P &lt;0.001), sUA (OR=1.006, P &lt;0.001) and LDL-C (OR=0.530, P =0.006) were independent factors of gout attack (&gt;20 times). Conclusion: Comorbidity screening involving dyslipidemia is often neglected in gout patients. Gout duration and sUA level are risk factors of multiple gout attacks. References: [1]Wang Y, Yan S, Li C et al. Risk Factors for Gout Developed From Hyperuricemia in China: A Five-Year Prospective Cohort Study. Rheumatol Int . 2013; 3: 705-10. Table 1. Comparisons of clinical and laboratory variables between male and female patients with gout Variable Male (n=553) Female (n=100) p Age (years) 47.7±15.9 51.3±14.5 0.040* BMI (kg/ m2) 24.5 (22.0-27.0) 23.3 (20.3-25.3) 0.001* Gout duration (years) 6.0 (3.0-11.0) 9.5 (4.0-15.0) 0.001* Gout attack times •≤5 209 (37.5) 33 (33.0) •6-10 97 (17.5) 22 (22.0) •11-20 70 (12.7) 22 (23.0) •&gt;20 177 (32.0) 23 (23.0) Comorbidies Hypertension, n (%) 138 (25.0) 32 (32.0) 0.140 Coronary heart disease, n (%) 57 (10.3) 10 (10.0) 0.926 Fatty liver disease 53 (9.6) 4 (4.0) 0.069 Laboratory testing •ALT(U/L) 25.0 (17.0-40.0) 19.2 (14.6-29.0) 0.003* •ALB(g/L) 43.5±6.3 42.4±3.9 0.025* •TB (μmol/L) 12.7 (9.0-17.3) 14.5 (12.1-17.4) 0.002* •BUN (mmol/L) 4.85 (3.98-6.27) 4.85 (3.91-4.82) 0.588 •Creatine (mmol/L) 94.0 (81.4-108.1) 73.8 (67.4-87.2) &lt;0.001* •UA (μmol/L) 528.4±141.1 363.8±122.9 &lt;0.001* •Glucose (mmol/L) 5.62±1.67 5.43±1.17 0.317 •TC (mmol/L) 5.05±1.15 5.09±1.10 0.726 •TG (mmol/L) 2.11±1.66 1.94±1.86 0.335 •HDL-C (mmol/L) 1.14±0.30 1.52±0.41 &lt;0.001* •LDL-C (mmol/L) 3.25±0.97 3.39±0.92 0.182 •ESR (mm/h) 40.1±32.4 37.4±20.8 0.402 •CRP (mg/L) 28.0±40.3 10.5±18.6 &lt;0.001* * p &lt; 0.05; BMI: body mass index; sUA: serum uric acid; ALT: alanine aminotransferase; ALB: albumin; TB: Total bilirubin; BUN: blood urea nitrogen; UA: uric acid; TC: total cholesterol; TG: triglycerides; HDL-C: high-density lipoprotein; LDL-C: Low-density lipoprotein; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein Acknowledgments: None. Disclosure of Interests: None declared