Öz
Gut hastalarında sıklıkla hipertansiyon(HT), kardiyovasküler hastalık, böbrek yetmezliği, diyabet mellitus(DM), obezite, hiperlipidemi(HL) veya metabolik sendrom dahil olmak üzere birden fazla komorbidite bulunur. Bu komorbiditeler ve tedavileri gut’ un seyrini ve tedavi edici ajan seçimini etkileyebilir. Bu çalışma gut’ a eşlik eden hastalıkları belirlemek amacıyla yapıldı. Çalışmamızda Aralık 2019- Nisan 2023 tarihleri arasında romatoloji polikliniğine başvuran gut tanısı alan hastaların demografik, klinik, biyokimyasal değişkenleri ile komorbid faktörleri geriye dönük araştırıldı. Çalışmaya 384 gut hastası dahil edildi (ortalama yaş 63,4 yıl olup erkeklerin oranı %71,6). Hastaların 299' una (%77,9) ilk kez tanı konulmuştu. Komorbid hastalığı olan hasta sayısı 319 (%83,0) idi. Komorbid hastalıklar değerlendirildiğinde en sık görülen hipertansiyondu(255 hasta, %58,5). Eşlik eden diğer hastalıklar sırasıyla 140 hastada (%36,4) HL, 132 hastada (%34,3) böbrek hastalığı, 120 hastada (%31,2) koroner arter hastalığı, 100 hastada (%26,0) DM, 65 hastada kalp yetmezliği (%16,9), 45 hastada (%11,7) osteoporoz, 26 hastada (%6,7) karaciğer hastalığı, 25 hastada (%6,5) inme, 20 hastada (%5,2) diğer hastalıklar, 18 hastada (%4,6) malignite ve herhangi bir komorbiditesi olmayan hasta sayısı ise 65 (%16,9) idi. Gutta komorbiditeler çok yaygındır ve hastalığın morbiditesini daha da arttırır ve tedavisini zorlaştırır. Bu nedenle gut hastaları, gut tedavisinin önemli bir parçası olarak ele alınması gereken komorbiditeler ve risk faktörleri açısından taranmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Kuo CF, Grainge MJ, Zhang W and Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nature reviews rheumatology. 2015 ;11(11), 649-662.
- 2. Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Annals of the rheumatic diseases. 2015; 74(4), 661-667.
- 3. Bardin T, Bouée S, Clerson P, Chalès G, Flipo RM, Richette P. et al. Prevalence of gout in the adult population of France. Arthritis care & research.2016; 68(2), 261-266.
- 4. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis & Rheumatism. 2011; 63: 3136-3141.
- 5. Kuo CF, Grainge MJ, See LC, Yu KH, Luo SF, Doherty M. et al. Epidemiology and management of gout in Taiwan: a nationwide population study. Arthritis research & therapy. 2015; 17(1), 1-10.
- 6. Winnard D, Wright C, Taylor WJ, Jackson G, Te Karu L, Dalbeth N. National prevalence of gout derived from administrative health data in Aotearoa New Zealand. Rheumatology. 2012; 51(5), 901-909.
- 7. Song P, Wang H, Xia W, Chang X, Wang M, An L. Prevalence and correlates of hyperuricemia in the middle-aged and older adults in China. Scientific reports. 2018; 8(1), 4314.
- 8. Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nature Reviews Rheumatology. 2020; 16(7), 380-390.
- 9. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007; 116: 894–900.
- 10. Abbott RD, Brand FN, Kannel WB, Castelli WP. Gout and coronary heart disease: the Framingham Study. Journal of clinical epidemiology. 1988; 41(3), 237-242.
- 11. Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006; 54(8): 2688-2696.
- 12. De Vera MA, Rahman MM, Bhole V, Kopec JA, Choi HK. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann Rheum Dis. 2010; 69(6): 1162-1164.
- 13. Kuo CF, Yu KH, See LC, Chou IJ, Ko YS, Luo SF. et al.. Risk of myocardial infarction among patients with gout: a nationwide population-based study. Rheumatology. 2013; 52(1), 111-117.
- 14. Richette P, Doherty M, Pascual E, Barskova V, Becce F, Bardin T. et al. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Annals of the rheumatic disease. 2020; 79(1), 31-38.
- 15. MacIsaac RJ, Ekinci EI, Premaratne E, Lu ZX, Seah JM, Jerums G. et al. The Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation does not improve the underestimation of Glomerular Filtration Rate (GFR) in people with diabetes and preserved renal function. BMC nephrology. 2015; (3) 16, 1-13.
- 16. Maiuolo, J, Oppedisano F, Mollace, V. et al. Regulation of uric acid metabolism and excretion. Int. J. Cardiol 2016; 213: 8–14.
- 17. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894-899.
- 18. Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Comorbidities in patients with gout prior to and following diagnosis: case-control study. Annals of the rheumatic diseases. 2016; 75(1), 210-217.
- 19.. Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 2012; 125:679–687.
- 20. Seminog OO, Goldacre MJ. Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies. Rheumatology (Oxford). 2013; 52:2251–2259.
- 21. Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open. 2012; 2:e000282.
- 22. Richette P, Perez-Ruiz F, Doherty M. et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol 2014; 10:654–61.
Öz
Patients with gout frequently have multiple comorbidities, including hypertension(HT), cardiovascular disease (CVD), renal impairment, diabetes mellitus(DM), obesity, hyperlipidemia(HL) or metabolic syndrome. These comorbidities and their treatment may have an effect on the choice of therapeutic agent. This study was to identify the comorbidities of gout. The study retrospectively investigated the demographic, clinical, and biochemical variables and comorbid factors of patients diagnosed with gout who applied to the rheumatology department between December 2019 and April 2023. 384 gout patients were included (mean age 63.4 years; men 71.6%). 299 (77.9%) of the patients received a diagnosis for the first time. The number of patients with comorbidities was 319 (83.0%). Hypertension was the most common comorbidity, observed in 255 patients (58.5%). Other comorbid diseases were HL in 140 patients (36.4%), kidney disease in 132 patients (34.3%), coronary artery disease(CAD) in 120 patients (31.2%), DM in 100 patients (26.0%), heart failure in 65 patients (16.9%), osteoporosis in 45 patients (11.7%), liver disease in 26 patients (6.7%), stroke in 25 patients (6.5%), other diseases in 20 patients (5.2%), malignancy in 18 patients (4.6%) and the number of patients without any comorbidities was 65 (16.9%). Comorbidities in gout are very common and add further to the disease's morbidity and make its management challenging. Patients with gout should therefore screened for comorbidities and risk factors, which should be addressed as an important part of gout management.
Anahtar Kelimeler
Kaynakça
- 1. Kuo CF, Grainge MJ, Zhang W and Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nature reviews rheumatology. 2015 ;11(11), 649-662.
- 2. Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Annals of the rheumatic diseases. 2015; 74(4), 661-667.
- 3. Bardin T, Bouée S, Clerson P, Chalès G, Flipo RM, Richette P. et al. Prevalence of gout in the adult population of France. Arthritis care & research.2016; 68(2), 261-266.
- 4. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis & Rheumatism. 2011; 63: 3136-3141.
- 5. Kuo CF, Grainge MJ, See LC, Yu KH, Luo SF, Doherty M. et al. Epidemiology and management of gout in Taiwan: a nationwide population study. Arthritis research & therapy. 2015; 17(1), 1-10.
- 6. Winnard D, Wright C, Taylor WJ, Jackson G, Te Karu L, Dalbeth N. National prevalence of gout derived from administrative health data in Aotearoa New Zealand. Rheumatology. 2012; 51(5), 901-909.
- 7. Song P, Wang H, Xia W, Chang X, Wang M, An L. Prevalence and correlates of hyperuricemia in the middle-aged and older adults in China. Scientific reports. 2018; 8(1), 4314.
- 8. Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nature Reviews Rheumatology. 2020; 16(7), 380-390.
- 9. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007; 116: 894–900.
- 10. Abbott RD, Brand FN, Kannel WB, Castelli WP. Gout and coronary heart disease: the Framingham Study. Journal of clinical epidemiology. 1988; 41(3), 237-242.
- 11. Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006; 54(8): 2688-2696.
- 12. De Vera MA, Rahman MM, Bhole V, Kopec JA, Choi HK. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann Rheum Dis. 2010; 69(6): 1162-1164.
- 13. Kuo CF, Yu KH, See LC, Chou IJ, Ko YS, Luo SF. et al.. Risk of myocardial infarction among patients with gout: a nationwide population-based study. Rheumatology. 2013; 52(1), 111-117.
- 14. Richette P, Doherty M, Pascual E, Barskova V, Becce F, Bardin T. et al. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Annals of the rheumatic disease. 2020; 79(1), 31-38.
- 15. MacIsaac RJ, Ekinci EI, Premaratne E, Lu ZX, Seah JM, Jerums G. et al. The Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation does not improve the underestimation of Glomerular Filtration Rate (GFR) in people with diabetes and preserved renal function. BMC nephrology. 2015; (3) 16, 1-13.
- 16. Maiuolo, J, Oppedisano F, Mollace, V. et al. Regulation of uric acid metabolism and excretion. Int. J. Cardiol 2016; 213: 8–14.
- 17. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894-899.
- 18. Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Comorbidities in patients with gout prior to and following diagnosis: case-control study. Annals of the rheumatic diseases. 2016; 75(1), 210-217.
- 19.. Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 2012; 125:679–687.
- 20. Seminog OO, Goldacre MJ. Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies. Rheumatology (Oxford). 2013; 52:2251–2259.
- 21. Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open. 2012; 2:e000282.
- 22. Richette P, Perez-Ruiz F, Doherty M. et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat Rev Rheumatol 2014; 10:654–61.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Romatoloji ve Artrit |
| Bölüm | ORİJİNAL MAKALELER / ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Ocak 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 46 Sayı: 1 |