OCCURRENCE OF THE METABOLIC SYNDROME AND ITS EFFECT ON CARDIOVASCULAR RISK IN PATIENTS WITH GOUT

Aim . To study the prevalence of metabolic syndrome (MS) and total risk of cardiovascular diseases (CVD) in patients with gout depending on the presence of MS. Material and methods . 56 patients (aged 53.3±10.9 years; men 82%) with verified primary chronic gout [median disease duration 5.7 (2.0-8.5) years] and MS (the main group) were included into the study. The control group included 30 patients (aged 55.3±12.5 years; men 73.3%) with MS without gout and other inflammatory diseases. The following parameters were evaluated in all patients: MS characteristics, serum uric acid, creatinine, fasting glucose, total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL cholesterol), low density lipoprotein cholesterol (LDL cholesterol), and high-sensitivity C-reactive protein. The total risk of CVD was calculated by the SCORE and PROCAM scales. Results . The incidence of arterial hypertension and hypertriglyceridemia was similar in the compared groups of patients with MS regardless of the presence of gout (p<0.001). Reduction in HDL cholesterol level was more typical for patients in the main group compared to patients with isolated MS (50% vs 23.3%; p<0.01). The total CVD risk was significantly higher in the patients of the main group compared to the patients with isolated MS [SCORE: 7.05 (3.84-9.03) vs 2.73 (1.71-4.97), p<0.01; PROCAM: 13.2 (6.55-23.0) vs 11.75 (7.0-17.5), p<0.05]. The strongest positive associations were found between the risk values on the PROCAM scale and the uric acid levels in the patients of both compared groups: correlation coefficients 0.13 and 0.25 in the patients of the main group and in patients with isolated MS, respectively. Conclusion . A high prevalence of the main risk factors in patients with gout was revealed. Serum levels of total cholesterol, LDL-C cholesterol and triglycerides made the main contribution to the increase in CVD risk according to SCORE and PROCAM scales. A higher CVD risk on the SCORE scale was found in patients with gout in combination with MS compared to patients with isolated MS (p<0.01). This fact indicates that namely a complex of metabolic disorders, developing both in gout and in MS, provides increase in the total CVD risk.