Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


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. 

About the Authors

I. I. Polskaya
Petrozavodsk State University
Russian Federation

MD, PhD, Associate Professor, Chair of Hospital Therapy,

Lenina prosp. 33, Petrozavodsk, Republic of Karelia, 185000

I. M. Marusenko
Petrozavodsk State University
Russian Federation

MD, PhD, Professor, Chair of Hospital Therapy,

Lenina prosp. 33, Petrozavodsk, Republic of Karelia, 185000

T. I. Kulagina
Petrozavodsk State University
Russian Federation

MD, PhD, Associate Professor, Chair of Hospital Therapy,

Lenina prosp. 33, Petrozavodsk, Republic of Karelia, 185000

N. N. Vezikova
Petrozavodsk State University
Russian Federation

MD, PhD, Professor, Head of Chair of Hospital Therapy,

Lenina prosp. 33, Petrozavodsk, Republic of Karelia, 185000


1. Reaven G.M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988; 37: 1595-607.

2. Barskova V.G., Yeliseyev M.S., Nasonov E.L., et al. Syndrome of insulinoresistance at sick of a gout and its influence on formation of clinical features of illness. Ter Arkhiv. 2004;76(5):51-6. (In Russ.) [Барскова В.Г., Елисеев М.С., Насонов Е.Л., и др. Синдром инсулинорезистентности у больных подагрой и его влияние на формирование клинических особенностей болезни. Тер архив. 2004;76(5):51-6].

3. Despres J.P., Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7122): 881-7.

4. Sidiropoulos P.I.,Karvounaris S.A., BoumpasD.T. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology, and clinical implications. Arthr ResTher. 2008;10:207-16.

5. Demidova T.J., Selivanova A.V., Ametov A.S. Role of a fatty fabric development of metabolic infringements in 2 types sick of a diabetes in a combination to adiposity. Ter Arkhiv. 2006;78(11):39-44. (In Russ.) [Демидова Т.Ю., Селиванова А.В., Аметов А.С. Роль жировой ткани развитии метаболических нарушений у больных сахарным диабетом 2 типа в сочетании с ожирением. Тер Архив. 2006;78(11):39-44].

6. Dorodneva E.F., Pugacheva T.A., Medvedeva I.V., et al. Metabolic syndrome. Ter Arkhiv. 2002;74(10):7-12. (In Russ.) [Дороднева ЕФ, Пугачева ТА, Медведева ИВ и др. Метаболический синдром. Тер Архив. 2002;74(10):7-12].

7. Mamedov M.N. Algorithms of diagnostics and treatment of a metabolic syndrome in out-patient conditions. Kardiologiia. 2005;45(5):92-9. (In Russ.) [Мамедов М.Н. Алгоритмы диагностики и лечения метаболического синдрома в клинико-амбулаторных условиях. Кардиология. 2005;45(5): 92-9].

8. Mamedov M.N. A metabolic syndrome: from disagreements to the compromise. Bolezni Serdtsa I Sosudov. 2006;1(4):2-6. (In Russ.) [Мамедов М.Н. Метаболический синдром: от разногласий к компромиссу. Болезни Сердца и Сосудов. 2006;1(4):2-6].

9. Mamedov M.N., Metelskaya V.А., Perova N.V. Metabolic syndrome: realisation ways atherotrombotic potential. Kardiologiia. 2000;40(2):83-9. (In Russ.) [Мамедов М.Н., Метельская В.А., Перова Н.В. Метаболический синдром: пути реализации атеротромбогенного потенциала. Кардиология. 2000;40(2):83-9].

10. Perova N.V., Metelskaya V.А., Oganov R.G. Metabolic syndrome: pathogenetic interrelations and correction directions. Ter Arkhiv. 2001;73(3):4-8. (In Russ.) [Перова Н.В., Метельская В.А., Оганов Р.Г. Метаболический синдром: патогенетические взаимосвязи и направления коррекции. Тер Архив. 2001;73(3):4-8].

11. Rojtberg G.E., Ushakova T.I., Doroch J.V. Role of insulinoresistance to diagnostics of a metabolic syndrome. Kardiologiia. 2004;44(3):94-9. (In Russ.) [Ройтберг Г.Е., Ушакова Т.И., Дорош Ж.В. Роль инсулинорезистентности в диагностике метаболического синдрома. Кардиология. 2004;44(3): 94-9].

12. Lakka H.M., Laaksonen D.E., Lakka T.A., et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288:2709-16.

13. Chazova I.E., Mychka V.B. A metabolic syndrome and an arterial hypertention. Arterial'naya Gipertenziya. 2002;7(1):7-10. (In Russ.) [Чазова И.Е., Мычка В.Б. Метаболический синдром и артериальная гипертензия. Артериальная Гипертензия. 2002;7(1):7-10].

14. Shostak N.A., Anichkov D.A. To a question on diagnostic criteria of a metabolic syndrome. Russkiy Meditsinskiy Zhurnal. 2002;10(27):55-7. (In Russ.) [Шостак Н.А., Аничков Д.А. К вопросу о диагностических критериях метаболического синдрома. Русский Медицинский Журнал. 2002;10(27):55-7].

15. Shostak N.A.,AnickovD.A. Metabolic syndrome: criteria of diagnostics and possibility antihypertentions therapy. Russkiy Meditsinskiy Zhurnal. 2002;10(27):58-61. (In Russ.) [Шостак Н.А., Аничков Д.А. Метаболический синдром: критерии диагностики и возможности антигипертензивной терапии. Русский Медицинский Журнал. 2002;10(27):58-61].

16. Erivansteva T.N., Olimpieva V.V., Chazova I.E., et al. The method of an establishment of presence of a metabolic syndrome at patients with an arterial hypertensia and adiposity. TerArhhiv. 2006;78(4):9-15. (In Russ.) [Эриванцева Т.Н., Олимпиева В.В., Чазова И.Е., и др. Метод установления наличия метаболического синдрома у пациентов с артериальной гипертензией и ожирением. Тер Архив. 2006;78(4):9-15].

17. Stark K., Reinhard W., Grassl M., et al. Common polymorphisms influencing serum uric acid levels contribute to susceptibility to gout, but not to coronary artery disease. PLoS ONE. 2009;4(11):1-7.

18. Guidelines of the experts of the All-Russian Scientific Society of Cardiologists on Diagnosis and Treatment of Metabolic Syndrome (second revision). Prakticheskaya Meditsina. 2010;5(44):81-101. (In Russ.) [Рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (второй пересмотр). Практическая Медицина. 2010;5(44):81-101].

19. Choi H.K., Ford E.S., Li C.Y., et al. Prevalence of the Metabolic syndrome in patients with gout: The Third National Health and Nutrition Examination Survey. Arthr Rheum. 2007;57(1):109-15.

20. Yoo T.W., Sung K.C., Shin H.S., et al. Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome. Circ J. 2005;69:928-33.

21. Edwards N.L. The role of hyperuricemia and gout in kidney and cardiovascular disease. Clev Clin J Med. 2008;75:13-6.

22. Nakagawa T., Mazzali M., Kang D.H., et al. Hyperuricemia causes glomerular hypertrophy in the rat. Am J Nephrol. 2003;23(1):2-7.

23. Ouppatham S., Bancha S., Choovichian P. The relationship of hyperuricemia and blood pressure in the Thai army population. J Postgrad Med. 2008;54(4):259-62.

24. Pillinger M.H., Goldfarb D.S., Keenan R.T., et al Gout and its comorbiditie. Bull NYU Hosp Joint Dis. 2010;68(3):199-203.

25. Redon J., Narkiewicz K. Hypertension in the metabolic syndrome. Pol Arch Med Wewn. 2009;119(4):255-60.

26. Feig D.I., Kang D., Johnson R.J. Uric acid and cardiovascular risk. N Engl J Med. 2008;359(17): 1811-21.

27. Schretlen D.J., Inscore A.B., Vannorsdall T.D., et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007;69:1418-23.

28. Wallace S.L., Robinson H., Masi A.T., et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthr Rheum. 1977;20:895-900.

29. VЗzguez-Mellado J., GarsiЗ C.G., Vazguez S.G., et al. Metabolic syndrome and ischemic heart disease in gout. J Clin Rheum. 2004;3(10):105-9.

30. Rho Y.H., Choi S.J., Lee Y.H., et al. The prevalence of metabolic syndrome in patients with gout: A multicenter study. J Korean Med Sci. 2005;20:1029-33.

31. Zuliania G., Volpatoa S., Galvania M., et al. Elevated C - reactive protein levels and metabolic syndrome in the elderly.Atherosclerosis. 2009;203(2):626-32.

32. Janssens H.U., van de Lisdonk E.H., Bor H., et al. Gout, just a nasty event or a cardiovascular signal? A study from primary care. Fam Pract. 2003;20:413-6.

33. Krishnan E., Svendsen K., Neaton J.D., et al. MRFIT research group long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med. 2008;168(10):1104-10.

For citation:

Polskaya I.I., Marusenko I.M., Kulagina T.I., Vezikova N.N. OCCURRENCE OF THE METABOLIC SYNDROME AND ITS EFFECT ON CARDIOVASCULAR RISK IN PATIENTS WITH GOUT. Rational Pharmacotherapy in Cardiology. 2017;13(4):476-481. (In Russ.)

Views: 385

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)