Skip to main content

Metabolic Syndrome and Gout

  • Chapter
  • First Online:
Studies on Arthritis and Joint Disorders

Abstract

The association between gout and the phenotype that we now recognize as metabolic syndrome has been recognized for thousands of years. With aging population, increasing prevalence of risk factors for metabolic syndrome, the number of people in the general population with metabolic syndrome and gout is large and is rising over time. This chapter summarizes contemporary literature on this topic as well as provides the latest data on the incidence and prevalence of metabolic syndrome in gout in the US. The potential pathophysiological links between metabolic syndrome and gout such as oxidative stress, and inflammation is discussed in the context of the epidemiologic data.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BC:

Before Christ

CHAOS:

Coronary artery disease hypertension, atherosclerosis, obesity, and stroke

CKD:

Chronic kidney disease

CKD EPI:

Chronic Kidney Disease Epidemiology Collaboration

LDL:

Low-density lipoprotein

MRFIT:

Multiple Risk Factor Intervention Trial

NCEP:

National Cholesterol Education Program

NHANES:

National Health and Nutrition Examination Survey

SIR:

Standardized incidence ratios

References

  1. Bhattacharjee S (2009) A brief history of gout. Int J Rheum Dis 12(1):61–63

    Article  PubMed  Google Scholar 

  2. Campion EW, Glynn RJ, DeLabry LO (1987) Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am J Med 82(3):421–426

    Article  PubMed  CAS  Google Scholar 

  3. Tausche AK, Unger S, Richter K et al (2006) [Hyperuricemia and gout: diagnosis and therapy]. Internist (Berl) 47(5):509–520, quiz 521

    Article  CAS  Google Scholar 

  4. Enomoto A, Kimura H, Chairoungdua A et al (2002) Molecular identification of a renal urate anion exchanger that regulates blood urate levels. Nature 417(6887):447–452

    PubMed  CAS  Google Scholar 

  5. Sarafidis PA, Nilsson PM (2006) The metabolic syndrome: a glance at its history. J Hypertens 24(4):621–626

    Article  PubMed  CAS  Google Scholar 

  6. Camus JP (1966) [Gout, diabetes, hyperlipemia: a metabolic trisyndrome]. Rev Rhum Mal Osteoartic 33(1):10–14

    PubMed  CAS  Google Scholar 

  7. Alberti KG, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120(16):1640–1645

    Article  PubMed  CAS  Google Scholar 

  8. Grundy SM, Cleeman JI, Daniels SR et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752

    Article  PubMed  Google Scholar 

  9. Koehler C, Ott P, Benke I et al (2007) Comparison of the prevalence of the metabolic syndrome by WHO, AHA/NHLBI, and IDF definitions in a German population with type 2 diabetes: the Diabetes in Germany (DIG) Study. Horm Metab Res 39(9):632–635

    Article  PubMed  CAS  Google Scholar 

  10. Haller H (1977) [Epidermiology and associated risk factors of hyperlipoproteinemia]. Z Gesamte Inn Med 32(8):124–128

    PubMed  CAS  Google Scholar 

  11. Krishnan E, Svendsen K, Neaton JD et al (2008) Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med 168(10):1104–1110

    Article  PubMed  Google Scholar 

  12. Chen SY, Chen CL, Shen ML (2007) Manifestations of metabolic syndrome associated with male gout in different age strata. Clin Rheumatol 26(9):1453–1457

    Article  PubMed  Google Scholar 

  13. Vazquez-Mellado J, Garcia CG, Vazquez SG et al (2004) Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 10(3):105–109

    Article  PubMed  Google Scholar 

  14. Choi HK, Ford ES, Li C et al (2007) Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 57(1):109–115

    Article  PubMed  Google Scholar 

  15. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (NCHS) (2012) National Health and Nutrition Examination Survey. 2009-2010. http://www.cdc.gov/nchs/nhanes.htm. Accessed 12 Feb 2012

  16. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Laboratory Manual. 2009-2010. http://www.cdc.gov/nchs/nhanes/nhanes2009-2010/labdoc_f.htm. Accessed 12 Feb 2012

  17. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Questionnaire. 2009-2010. http://www.cdc.gov/nchs/nhanes/nhanes2009-2010/quex09_10.htm. Accessed 12 Feb 2012

  18. Gelber AC, Klag MJ, Mead LA et al (1997) Gout and risk for subsequent coronary heart disease. The Meharry-Hopkins Study. Arch Intern Med 157(13):1436–1440

    Article  PubMed  CAS  Google Scholar 

  19. McAdams MA, Maynard JW, Baer AN et al (2011) Reliability and sensitivity of the self-report of physician-diagnosed gout in the campaign against cancer and heart disease and the atherosclerosis risk in the community cohorts. J Rheumatol 38(1):135–141

    Article  PubMed  Google Scholar 

  20. Baker JF, Krishnan E, Chen L et al (2005) Serum uric acid and cardiovascular disease: recent developments, and where do they leave us? Am J Med 118(8):816–826

    Article  PubMed  CAS  Google Scholar 

  21. Zhu Y, Pandya BJ, Choi HK (2011) Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum 63(10):3136–3141

    Article  PubMed  Google Scholar 

  22. Levey AS, Stevens LA, Schmid CH et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612

    Article  PubMed  Google Scholar 

  23. Chobanian AV, Bakris GL, Black HR et al (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289(19):2560–2572

    Article  PubMed  CAS  Google Scholar 

  24. American Diabetes Association (2011) Diagnosis and classification of diabetes mellitus. Diabetes Care 34(Suppl 1):S62–S69

    Article  Google Scholar 

  25. Krishnan E, Lingala B, Bhalla V (2012) Low-level lead exposure and the prevalence of gout: an observational study. Ann Intern Med 157(4):233–241

    Google Scholar 

  26. Centers for Disease Control and Prevention (CDC) (2004) National Center for Health Statistics (NCHS): NHANES Laboratory Procedure Manual: Lead Cadmium Mercury. http://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/PbCd_E_met_lead_cadmium.pdf. Accessed 15 Mar 2011

  27. Centers for Disease Control and Prevention (CDC) (2012) National Center for Health Statistics (NCHS). NHANES – Analytical Guidelines. 2010. http://www.cdc.gov/nchs/nhanes.htm. Accessed 12 Feb 2012

  28. Anderson R, Rosenberg H (1998) Age standardization of death rates: implementation of the year 2000 Standard. In: Statistics NCoH (ed) National vital statistics reports, vol 47

    Google Scholar 

  29. Sherwin R, Kaelber CT, Kezdi P et al (1981) The multiple risk factor intervention trial (MRFIT) II. The development of the protocol. Prev Med 10(4):402–425

    Article  PubMed  CAS  Google Scholar 

  30. Zukel WJ, Paul O, Schnaper HW (1981) The multiple risk factor intervention trial (MRFIT). I. Historical perspective. Prev Med 10(4):387–401

    Article  PubMed  CAS  Google Scholar 

  31. Neaton JD, Grimm RH Jr, Cutler JA (1987) Recruitment of participants for the multiple risk factor intervention trial (MRFIT). Control Clin Trials 8(4 Suppl):41S–53S

    Article  PubMed  CAS  Google Scholar 

  32. Krishnan E, Kwoh C, Schumacher HR et al (2007) Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension 49:1–2

    Google Scholar 

  33. Krishnan E, Baker JF, Furst DE et al (2006) Gout and the risk of acute myocardial infarction. Arthritis Rheum 54(8):2688–2696

    Article  PubMed  CAS  Google Scholar 

  34. Krishnan E (2008) Gout and coronary artery disease: epidemiologic clues. Curr Rheumatol Rep 10(3):249–255

    Article  PubMed  CAS  Google Scholar 

  35. Arromdee E, Michet CJ, Crowson CS et al (2002) Epidemiology of gout: is the incidence rising? J Rheumatol 29(11):2403–2406

    PubMed  Google Scholar 

  36. Wallace SL, Robinson H, Masi AT et al (1977) Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 20(3):895–900

    Article  PubMed  CAS  Google Scholar 

  37. Squadrito GL, Cueto R, Splenser AE et al (2000) Reaction of uric acid with peroxynitrite and implications for the mechanism of neuroprotection by uric acid. Arch Biochem Biophys 376(2):333–337

    Article  PubMed  CAS  Google Scholar 

  38. Corry DB, Eslami P, Yamamoto K et al (2008) Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens 26(2):269–275

    Article  PubMed  CAS  Google Scholar 

  39. Kanellis J, Kang DH (2005) Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol 25(1):39–42

    Article  PubMed  CAS  Google Scholar 

  40. Khosla UM, Zharikov S, Finch JL et al (2005) Hyperuricemia induces endothelial dysfunction. Kidney Int 67(5):1739–1742

    Article  PubMed  Google Scholar 

  41. Kato M, Hisatome I, Tomikura Y et al (2005) Status of endothelial dependent vasodilation in patients with hyperuricemia. Am J Cardiol 96(11):1576–1578

    Article  PubMed  CAS  Google Scholar 

  42. Patterson RA, Horsley ET, Leake DS (2003) Prooxidant and antioxidant properties of human serum ultrafiltrates toward LDL: important role of uric acid. J Lipid Res 44(3):512–521

    Article  PubMed  CAS  Google Scholar 

  43. Farquharson CA, Butler R, Hill A et al (2002) Allopurinol improves endothelial dysfunction in chronic heart failure. Circulation 106(2):221–226

    Article  PubMed  CAS  Google Scholar 

  44. George J, Carr E, Davies J et al (2006) High-dose allopurinol improves endothelial function by profoundly reducing vascular oxidative stress and not by lowering uric acid. Circulation 114(23):2508–2516

    Article  PubMed  CAS  Google Scholar 

  45. Staprans I, Pan XM, Rapp JH et al (2005) The role of dietary oxidized cholesterol and oxidized fatty acids in the development of atherosclerosis. Mol Nutr Food Res 49(11):1075–1082

    Article  PubMed  CAS  Google Scholar 

  46. Tsutsumi Z, Moriwaki Y, Takahashi S et al (2004) Oxidized low-density lipoprotein autoantibodies in patients with primary gout: effect of urate-lowering therapy. Clin Chim Acta 339(1–2):117–122

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eswar Krishnan M.D., M.Phil. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Krishnan, E. (2013). Metabolic Syndrome and Gout. In: Alcaraz, M., Gualillo, O., Sánchez-Pernaute, O. (eds) Studies on Arthritis and Joint Disorders. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-6166-1_13

Download citation

Publish with us

Policies and ethics