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OP0312 Association of Insuline Resistance and Hypertension with Renal Clearance of Uric Acid in Males with Gout and Normal Renal Function
  1. F. Perez-Ruiz1
  1. 1Rheumatology Division. BioCruces Health Institute., HOSPITAL UNIVERSITARIO CRUCES, Baracaldo, Spain

Abstract

Background Genetic studies have associated the Glut9 renal transporter with hyperuricemia and gout. Insulin resistance has also been associated to hyperuricemia and gout due to a reduction of renal clearance of uric acid. A direct link between renal clearance of uric acid and insulin resistance is an attractive physiopathologic hypothesis.

Objectives To study whether there is a correlation between clearance of urate and insulin resistance in gout patients with normal renal function.

Methods Consecutive male patients with crystal-proven gout were evaluated if not on any drug with urate-lowering properties, show normal renal function (CKD 1 with no altered urine sediment), fasting glucose < 120 mg/dl, normal diet and alcohol avoidance. HOMA-IR was calculated with fasting glucose and insulin determinations. Inefficient excretion of uric acid being defined as clearance of uric acid < 6 ml/min/1.73 sqm. Hypertension, previous ethanol intake, body mass index, time from onset, age, vascular events, renal lithiasis, total cholesterol, HLD-cholesterol, LDL-cholesterol, triglycerides, glycosilated hemoglobin, number of flares, and presence of tophi were also recorded in the database.

Results One hundred and twenty-nine male patients were included for analysis. Age was 53 years (28-60), time from onset 5.5 (3-11) years. Previous ethanol intake > 15 g/day, hypertension, glycosilated hemoglobin, clearance of creatinine, and HOMA-IR were associated to clearance of uric acid in bivariate regression analysis. Multivariate regression analysis showed that HOMA-IR and hypertension were the only variables predictive of the model. HOMA-IR showed a R2 0.27. ROC area was 0.869 and a HOMA-IR cut-off >2.7 showed 80% sensitivity ad 81% specificity.

Conclusions Insulin resistance, but also hypertension, was associated with lower clearance of uric acid in a series of phenotype-selected male gout patients, showing a plausible link between glucose metabolism and sugar transporters of uric acid that deserves further investigation.

Disclosure of Interest F. Perez-Ruiz Consultant for: Ardea, Savient, Menarini, Astra, Metabolex, Pfizer, Novartis, SOBI, Speakers bureau: Menarini

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