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Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis

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Abstract

The study was performed to confirm the high prevalence of metabolic syndrome in gouty patients and to define the relationship between insulin resistance and gouty arthritis. We recruited 83 patients with gouty arthritis and checked clinical factors according to the diagnostic criteria of metabolic syndrome from the ATP III guidelines and WHO Asia-Pacific obesity criteria recommendations. We also assessed the clinical characteristics of subjects and homeostasis model assessment of insulin resistance (HOMA-IR) and compared with previous study groups as controls. The prevalence of metabolic syndrome in patients with gout was 30.1% according to ATP III criteria and 50.6% with WHO Asia-Pacific adjustment and is significantly higher than the previous control study groups (ATP III: 5.2, 10.6%, WHO Asia-Pacific adjustment: 9.8, 13.9%). The mean value of HOMA-IR in patients with gout was 2.63 ± 1.36 and is significantly higher than control study (1.91 ± 1.01, P < 0.05). There were significant correlations between 24-h urinary uric acid excretion and waist circumference (r 2 = 0.225, P = 0.049), fasting insulin (r 2 = 0.241, P = 0.035), and insulin resistance (HOMA-IR) (r 2 = 0.271, P = 0.017). There were significant correlations between insulin resistance and waist circumference (r 2 = 0.341, P < 0.01), BMI (r 2 = 0.390, P < 0.01). The value of HOMA-IR (insulin resistance) and the prevalence of metabolic syndrome in patients with gout are significantly higher than normal healthy control groups. The hyperuricemia in gout might be caused by the increased adiposity associated with insulin resistance.

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References

  1. Emmerson B (1998) Hyperlipidaemia in hyperuricaemia and gout. Ann Rheum Dis 57(9):509–510

    Article  PubMed  CAS  Google Scholar 

  2. Fam AG (2002) Gout, diet, and the insulin resistance syndrome. J Rheumatol 29(7):1350–1355

    PubMed  CAS  Google Scholar 

  3. Choi HK, Mount DB, Reginato AM; American College of Physicians; American Physiological Society (2005) Pathogenesis of gout. Ann Intern Med 143(7):499–516

    Google Scholar 

  4. Vázquez-Mellado J, García CG, Vázquez SG, Medrano G, Ornelas M, Alcocer L, Marquez A, Burgos-Vargas R (2004) Metabolic syndrome and ischemic heart disease in gout. J Clin Rheumatol 10(3):105–109

    Article  PubMed  Google Scholar 

  5. Rho YH, Choi SJ, Lee YH, Ji JD, Choi KM, Baik SH, Chung SH, Kim CG, Choe JY, Lee SW, Chung WT, Song GG (2005) The prevalence of metabolic syndrome in patients with gout: a multicenter study. J Korean Med Sci 20(6):1029–1033

    Article  PubMed  CAS  Google Scholar 

  6. Lee WY, Park JS, Noh SY, Rhee EJ, Kim SW, Zimmet PZ (2004) Prevalence of the metabolic syndrome among 40,698 Korean metropolitan subjects. Diabetes Res Clin Pract 65(2):143–149

    Article  PubMed  Google Scholar 

  7. Rho YH, Choi SJ, Lee YH, Ji JD, Choi KM, Baik SH, Song GG (2004) Prevalence of the metabolic syndrome in patients with gout. J Korean Rheum Assoc 11(4):349–357

    Google Scholar 

  8. Trevisan M, Liu J, Bahsas FB, Menotti A (1998) Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group. Am J Epidemiol 148(10):958–966

    PubMed  CAS  Google Scholar 

  9. Ford ES (2005) Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 28(7):1769–1778

    Article  PubMed  Google Scholar 

  10. Lee J, Sparrow D, Vokonas PS, Landsberg L, Weiss ST (1995) Uric acid and coronary heart disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndrome. The Normative Aging Study. Am J Epidemiol 142(3):288–294

    PubMed  CAS  Google Scholar 

  11. Rathmann W, Funkhouser E, Dyer AR, Roseman JM (1998) Relations of hyperuricemia with the various components of the insulin resistance syndrome in young black and white adults: the CARDIA study. Coronary artery risk development in young adults. Ann Epidemiol 8(4):250–261

    Article  PubMed  CAS  Google Scholar 

  12. Facchini F, Chen YD, Hollenbeck CB, Reaven GM (1991) Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 266(21):3008–3011

    Article  PubMed  CAS  Google Scholar 

  13. Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yü TF (1977) Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 20(3):895–900

    Article  PubMed  CAS  Google Scholar 

  14. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419

    Article  PubMed  CAS  Google Scholar 

  15. Park SH, Lee WY, Kim SW (2003) The relative risks of the metabolic syndrome defined by adult treatment panel 3 according to insulin resistance in Korean population. Korean J Med 64(5):552–561

    Google Scholar 

  16. National Institutes of Health (2001) Third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). NIH Publication 01-3670. National Institutes of Health, Bethesda

  17. Steering Committee of the WHO Western Pacific Region, IASO & IOTF (2000) The Asia-Pacific perspective: Redefining obesity and its treatment. Steering Committee of the WHO Western Pacific Region, IASO & IOTF, Australia

  18. Park JS, Park HD, Yun JW, Jung CH, Lee WY, Kim SW (2002) Prevalence of the metabolic syndrome as defined by NCEP—ATPIII among the urban Korean population. Korean J Med 63(3):290–299

    Google Scholar 

  19. Lebovitz HE (2001) Insulin resistance: definition and consequences. Exp Clin Endocrinol Diabetes 109:S135–S148

    Article  PubMed  CAS  Google Scholar 

  20. Bogardus C, Lillioja S, Mott DM, Hollenbeck C, Reaven G (1985) Relationship between degree of obesity and in vivo insulin action in man. Am J Physiol 248:E286–E291

    PubMed  CAS  Google Scholar 

  21. Lin KC, Lin HY, Chou P (2000) Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J Rheumatol 27(4):1045–1050

    PubMed  CAS  Google Scholar 

  22. Kim EH, Jeon KM, Park KW, Kim HJ, Ahn JK, Jeon CH, Cha HS, Koh EM (2004) The prevalence of gout among hyperuricemic population. J Korean Rheum Assoc 11(1):7–13

    Google Scholar 

  23. Vuorinen-Markkola H, Yki-Järvinen H (1994) Hyperuricemia and insulin resistance. J Clin Endocrinol Metab 78(1):25–29

    Article  PubMed  CAS  Google Scholar 

  24. Clausen JO, Borch-Johnsen K, Ibsen H, Pedersen O (1998) Analysis of the relationship between fasting serum uric acid and the insulin sensitivity index in a population-based sample of 380 young healthy Caucasians. Eur J Endocrinol 138(1):63–69

    Article  PubMed  CAS  Google Scholar 

  25. Rocić B, Vucić-Lovrencić M, Poje N, Bertuzzi F (2005) Uric acid may inhibit glucose-induced insulin secretion via binding to an essential arginine residue in rat pancreatic beta-cells. Bioorg Med Chem Lett 15(4):1181–1184

    Article  PubMed  Google Scholar 

  26. Hara H, Egusa G, Yamakido M (1996) Incidence of non-insulin-dependent diabetes mellitus and its risk factors in Japanese-Americans living in Hawaii and Los Angeles. Diabet Med 13(6):S133–S142

    PubMed  CAS  Google Scholar 

  27. Lin KC, Tsai ST, Lin HY, Chou P (2004) Different progressions of hyperglycemia and diabetes among hyperuricemic men and women in the kinmen study. J Rheumatol 31(6):1159–1165

    PubMed  Google Scholar 

  28. Chou P, Li CL, Wu GS, Tsai ST (1998) Progression to type 2 diabetes among high-risk groups in Kin-Chen, Kinmen. Exploring the natural history of type 2 diabetes. Diabetes Care 21(7):1183–1187

    Article  PubMed  CAS  Google Scholar 

  29. Nakanishi N, Okamoto M, Yoshida H, Matsuo Y, Suzuki K, Tatara K (2003) Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers. Eur J Epidemiol 18(6):523–530

    Google Scholar 

  30. Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K, Taniguchi Y, Hayashi T, Tsumura K, Endo G, Fujii S, Okada K (2001) Serum uric acid and the risk for hypertension and Type 2 diabetes in Japanese men: The Osaka Health Survey. J Hypertens 19(7):1209–1215

    Article  PubMed  CAS  Google Scholar 

  31. Bakker SJ, Gans RO, ter Maaten JC, Teerlink T, Westerhoff HV, Heine RJ (2001) The potential role of adenosine in the pathophysiology of the insulin resistance syndrome. Atherosclerosis 155(2):283–290

    Article  PubMed  CAS  Google Scholar 

  32. Roubenoff R, Klag MJ, Mead LA, Liang KY, Seidler AJ, Hochberg MC (1991) Incidence and risk factors for gout in white men. JAMA 266(21):3004–3007

    Article  PubMed  CAS  Google Scholar 

  33. Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J (2000) Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis 59(7):539–543

    Article  PubMed  CAS  Google Scholar 

  34. Boden G (1996) Fatty acids and insulin resistance. Diabetes Care 19(4):394–395

    Article  PubMed  CAS  Google Scholar 

  35. Boden G (1997) Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. Diabetes 46(1):3–10

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A084144).

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Authors and Affiliations

  1. Department of Pharmacy Practice, University of Rhode Island, Kingston, RI, 02881, USA

    Han-Gyul Yoo

  2. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyungnam, 660-751, South Korea

    Sang-Il Lee

  3. Department of Pharmacology, Chonbuk National University Medical School, Jeonju, Jeonbuk, 561-712, South Korea

    Han-Jung Chae

  4. Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-756, South Korea

    Seoung Ju Park, Yong Chul Lee & Wan-Hee Yoo

  5. Research Center for Pulmonary Disorders, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, Jeonbuk, 561-712, South Korea

    Han-Jung Chae, Seoung Ju Park, Yong Chul Lee & Wan-Hee Yoo

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  1. Han-Gyul Yoo
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  2. Sang-Il Lee
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Correspondence to Wan-Hee Yoo.

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H.-G. Yoo and S.-I. Lee contributed equally to this work.

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Yoo, HG., Lee, SI., Chae, HJ. et al. Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis. Rheumatol Int 31, 485–491 (2011). https://doi.org/10.1007/s00296-009-1304-x

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  • DOI: https://doi.org/10.1007/s00296-009-1304-x

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