Pilot study: asymptomatic hyperuricemia patients with obesity and nonalcoholic fatty liver disease have increased risk of double contour sign
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Double contour sign (DCS) is a representative ultrasonographic finding in gout. DCS is evidence of monosodium urate deposit in gouty arthritis and has been identified in some patients with asymptomatic hyperuricemia. However, the specific characteristics of asymptomatic hyperuricemia in patients with DCS have not yet been revealed. Methods: We enrolled patients with incidentally found hyperuricemia. Baseline characteristics were compared between asymptomatic hyperuricemia patients with and without DCS. Logistic regression analysis was performed to determine associated factors for DCS in patients with asymptomatic hyperuricemia. Results: A total of 62 patients with asymptomatic hyperuricemia were enrolled, and 22 of the patients showed DCS. The metatarsophalangeal were the most commonly affected joints, and differences between asymptomatic hyperuricemia patients with and without DCS were seen in aspects of class II obesity and nonalcoholic fatty liver disease (NAFLD). Multivariate logistic regression analysis demonstrated that class II obesity and NAFLD significantly increased the risk of DCS in asymptomatic hyperuricemia patients (odds ratio [OR], 6.58, p = 0.022; OR, 5.21, p = 0.020, respectively). Conclusions: Asymptomatic hyperuricemia patients with class II obesity and NAFLD had increased risk of DCS. Determining the presence of crystal deposition, such as DCS, among patients with asymptomatic hyperuricemia might help determine whether early pharmacologic intervention is needed, especially with severe obesity or NAFLD.
Abstract
Background/Aims: Double contour sign (DCS) is a representative ultrasonographic finding in gout. DCS is evidence of monosodium urate deposit in gouty arthritis and has been identified in some patients with asymptomatic hyperuricemia. However, the specific characteristics of asymptomatic hyperuricemia in patients with DCS have not yet been revealed. Methods: We enrolled patients with incidentally found hyperuricemia. Baseline characteristics were compared between asymptomatic hyperuricemia patients with and without DCS. Logistic regression analysis was performed to determine associated factors for DCS in patients with asymptomatic hyperuricemia. Results: A total of 62 patients with asymptomatic hyperuricemia were enrolled, and 22 of the patients showed DCS. The metatarsophalangeal were the most commonly affected joints, and differences between asymptomatic hyperuricemia patients with and without DCS were seen in aspects of class II obesity and nonalcoholic fatty liver disease (NAFLD). Multivariate logistic regression analysis demonstrated that class II obesity and NAFLD significantly increased the risk of DCS in asymptomatic hyperuricemia patients (odds ratio [OR], 6.58, p = 0.022; OR, 5.21, p = 0.020, respectively). Conclusions: Asymptomatic hyperuricemia patients with class II obesity and NAFLD had increased risk of DCS. Determining the presence of crystal deposition, such as DCS, among patients with asymptomatic hyperuricemia might help determine whether early pharmacologic intervention is needed, especially with severe obesity or NAFLD.
참고문헌 (25)
- Campion EW, "Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study", Am J Med, 82, pp.421~426 (1987)
- Lin KC, "The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study", J Rheumatol, 27, pp.1501~1505 (2000)
- Dalbeth N, "Relationship between serum urate concentration and clinically evident incident gout : an individual participant data analysis", Ann Rheum Dis, 77, pp.1048~1052 (2018)
- Roughley MJ, "Gout and risk of chronic kidney disease and nephrolithiasis : meta-analysis of observational studies", Arthritis Res Ther, 17, pp.90~ (2015)
- Gonzalez-Senac NM, "Metabolic syndrome in primary gout", Nucleosides Nucleotides Nucleic Acids, 33, pp.185~191 (2014)
- Abeles AM, "Hyperuricemia, gout, and cardiovascular disease : an update", Curr Rheumatol Rep, 17, pp.13~ (2015)
- Li L, "Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies", BMC Nephrol, 15, pp.122~ (2014)
- Wang J, "Hyperuricemia and risk of incident hypertension : a systematic review and meta-analysis of observational studies", PLoS One, 9, pp.e114259~ (2014)
- Li C, "Metabolic syndrome, diabetes, and hyperuricemia", Curr Opin Rheumatol, 25, pp.210~216 (2013)
- Richette P, "2016 Updated EULAR evidence-based recommendations for the management of gout", Ann Rheum Dis, 76, pp.29~42 (2017)
- Gutierrez M, "International consensus for ultrasound lesions in gout: results of Delphi process and web-reliability exercise", Rheumatology (Oxford), 54, pp.1797~1805 (2015)
- Neogi T, "2015 Gout classification criteria : an American College of Rheumatology", European League Against Rheumatism collaborative initiative, 2015, pp.74, 1789~1798
- Ogdie A, "Imaging modalities for the classification of gout : systematic literature review and meta-analysis", Ann Rheum Dis, 74, pp.1868~1874 (2015)
- Pineda C, "Joint and tendon subclinical involvement suggestive of gouty arthritis in asymptomatic hyperuricemia : an ultrasound controlled study", Arthritis Res Ther, 13, pp.R4~ (2011)
- Ben Salem C, "Drug-induced hyperuricaemia and gout", Rheumatology(Oxford), 56, pp.679~688 (2017)
- Towiwat P, "The association of vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and gout", Int J Rheum Dis, 18, pp.495~501 (2015)
- Martinoli C, "Musculoskeletal ultrasound : technical guidelines", Insights Imaging, 1, pp.99~141 (2010)
- Felix Stickel, "Pathophysiology and Management of Alcoholic Liver Disease: Update 2016", Gut and Liver, 11(2), pp.173~188 (2017), 거트앤리버 소화기연관학회협의회
- Committee for the Korean Guidelines for the Management of Dyslipidemia, "2015 Korean Guidelines for the Management of Dyslipidemia: Executive Summary (English Translation)", Korean Circulation Journal, 46(3), pp.275~306 (2016), 대한심장학회[DOI]
- 김미경, "2014 Clinical Practice Guidelines for Overweight and Obesity in Korea", Endocrinology and Metabolism, 29(4), pp.405~409 (2014), 대한내분비학회
- Thottam GE, "Gout and metabolic syndrome : a tangled web", Curr Rheumatol Rep, 19, pp.60~ (2017)
- Sircar D, "Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia : a 6-month, double-blind, randomized, placebo-controlled trial", Am J Kidney Dis, 66, pp.945~950 (2015)
- Dalbeth N, "Hyperuricaemia and gout : time for a new staging system", Ann Rheum Dis, 73, pp.1598~1600 (2014)
- Stewart S, "comparison with normouricemic individuals", Arthritis Care Res(Hoboken), 69, pp.875~883 (2017)
- Bo S, "Associations between serum uric acid and adipokines, markers of inflammation, and endothelial dysfunction", J Endocrinol Invest, 31, pp.499~504 (2008)