Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options

BMC Medicine

Minireview

Pascal Richette¹  Thomas Bardin² 

[1] Université Paris Diderot, UFR médicale, Paris, France;Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Service de Rhumatologie, Paris, Cedex, France;INSERM 1132, Université Paris-Diderot, Hôpital Lariboisière, Paris, France;Université Paris Diderot, UFR médicale, Paris, France;Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Service de Rhumatologie, Paris, Cedex, France;INSERM 1132, Université Paris-Diderot, Hôpital Lariboisière, Paris, France;French-Vietnamese Research Center on Gout, Ho Chi Minh City, Vietnam;

关键词: Obesity;    Hypertension;    Type-2 diabetes;    Dyslipidaemia;    Coronary heart disease;    Heart failure;    Atrial fibrillation;    Cardiovascular death;    Colchicine;    Urate-lowering drugs;   

DOI  :  10.1186/s12916-017-0890-9

 received in 2017-04-11, accepted in 2017-06-12,  发布年份 2017

来源: Springer

【 摘 要 】

Gout, the most prevalent inflammatory arthritis worldwide, is associated with cardiovascular and renal diseases, and is an independent predictor of premature death. The frequencies of obesity, chronic kidney disease (CKD), hypertension, type 2 diabetes, dyslipidaemias, cardiac diseases (including coronary heart disease, heart failure and atrial fibrillation), stroke and peripheral arterial disease have been repeatedly shown to be increased in gout. Therefore, the screening and care of these comorbidities as well as of cardiovascular risk factors are of outmost importance in patients with gout. Comorbidities, especially CKD, and drugs prescribed for their treatment, also impact gout management. Numerous epidemiological studies have shown the association of asymptomatic hyperuricaemia with the above-mentioned diseases and cardiovascular risk factors. Animal studies have also produced a mechanistic approach to the vascular toxicity of soluble urate. However, causality remains uncertain because confounders, reverse causality or common etiological factors might explain the epidemiological results. Additionally, these uncertainties remain unsolved despite recent studies using Mendelian randomisation or therapeutic approaches. Thus, large randomised placebo-controlled trials are still needed to assess the benefits of treating asymptomatic hyperuricaemia.

【 授权许可】

CC BY   
© The Author(s). 2017