Obesity, Echocardiographic Changes and Framingham Risk Score in the Spectrum of Gout: A Cross-Sectional Study
Obesity, Echocardiographic Changes and Framingham Risk Score in the Spectrum of Gout: A Cross-Sectional Study
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DOI：
10.5606/archrheumatol.2019.7062
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发表时间：
2019-06-01
影响因子：
1.1
通讯作者：
Kolarov, Zlatimir
中科院分区：
文献类型：
--
作者：
Gancheva, Rada;Koundurdjiev, Atanas;Kolarov, Zlatimir
目的：本研究的目的是建立心血管疾病的风险在肥胖和非肥胖患者在痛风阶段通过使用Fragrance风险评分（FRS）和经胸超声心动图Patients and methods：这项单中心横断面研究包括201例患者（160例男性，41例女性;平均年龄56.9 ± 13岁;范围20 - 89岁），包括52例无症状高尿酸血症，86例无痛风石的痛风性关节炎和63例痛风石患者。计算体重指数（BMI）和FRS。测量左房（LA）、室间隔、左室后壁（PW）、左室短轴缩短率（FS）、二尖瓣环收缩期流速（S '）、二尖瓣环舒张早期流速（E'）及二尖瓣环与二尖瓣环舒张早期流速比值（E/E '）。结果：无症状高尿酸血症、痛风性关节炎、痛风性痛风石患者的FRS、FS、S '、E'、E/E'与非肥胖组比较，差异无统计学意义（P > 0. 05）。三个疾病分级中的肥胖患者具有较大的LA（p=0.007，p=0.004，p=0.039）和较厚的PW（p=0.002，p=0.037，p=0.007）。BMI增加独立预测无症状高尿酸血症患者PW增厚（R-2 =0.319），痛风性关节炎不伴痛风石（R-2 =0.093）和痛风性痛风石（R-2 =0.068）。尽管在痛风谱中肥胖和非肥胖患者之间的FRS和功能性收缩和舒张参数缺乏差异，心脏形态学改变在肥胖患者中更为明显。在痛风性痛风石中，较高的尿酸盐负荷和慢性炎症可能导致这些改变，因为肥胖会使它们发生变化。
Objectives: This study aims to establish cardiovascular risk in obese and non-obese patients in stages of gout by using Framingham risk score (FRS) and transthoracic echocardiography.Patients and methods: This single-center cross-sectional study encompassed 201 patients (160 males, 41 females; mean age 56.9 +/- 13 years; range 20 to 89 years) including 52 asymptomatic hyperuricemia, 86 gouty arthritis without tophi, and 63 gouty tophi patients. body mass index (BMI) and FRS were calculated. Left atrium (LA), interventricular septum, posterior wall (PW) of the left ventricle, fractional shortening (FS), mitral annular systolic velocity (S'), mitral annular early diastolic velocity (E') and transmitral to mitral annular early diastolic velocity ratio (E/E') were measured. Data were analyzed by Kolmogorov-Smirnov test Shapiro-Wilk test t-test Mann-Whitney U test, analysis of variance test and multiple linear regression models.Results: There was no significant difference in FRS, FS, S', E' and E/E' between obese and non-obese patients with asymptomatic hyperuricemia, gouty arthritis without tophi or gouty tophi. Obese patients in the three disease gradations had larger LA (p=0.007, p=0.004, p=0.039) and thicker PW (p=0.002, p=0.037, p=0.007). Increased BMI independently predicted the thickening of the PW in asymptomatic hyperuricemia (R-2 =0.319), gouty arthritis without tophi (R-2 =0.093) and gouty tophi (R-2 =0.068).Conclusion: Despite the lack of difference in FRS and functional systolic and diastolic parameters between obese and non-obese patients in the spectrum of gout, morphological heart changes were more pronounced in obese patients. In gouty tophi, it is possible that higher urate load together with chronic inflammation contribute for the alterations, as obesity worsens them.