Background Gout is a chronic inflammatory disease of which the development is associated with metabolic abnormality caused by obesity. However, there are a substantial number of non-obese patients (body mass index (BMI) <25 kg/m2) who develop gout in Korea. As it has been suggested that accumulation of visceral fat, rather than subcutaneous fat is associated with metabolic abnormality and hyperuricemia in patients with gout, we hypothesized that visceral fat accumulation was increased in non-obese gout patients.
Objectives In the present study, we characterized the components of metabolic syndrome, and examined the association of visceral fat obesity and gout, especially focused on non-obese population.
Methods One hundred and three male patients with primary gout and 204 age - matched healthy controls who attended health check-up examination were recruited by medical chart review. Visceral fat area (VFA) was measured by bioelectrical impedance analysis (BIA), and VFA>100cm2 was defined as visceral fat obesity (VFO). The frequency of VFO was compared in patients and control groups. The frequency of metabolic syndrome as well as its components was investigated.
Results The prevalence of metabolic syndrome in patients with gout was 31.7% (33/104) according to modified ATP III criteria. BMI (26.3±3.8 vs. 23.4±2.4 kg/m2, P<0.001), waist circumference (91.2±9.7 vs. 82.3±7.5 cm, P<0.001), total fat mass (20.8±7.6 vs. 15.1±4.4 kg) the serum triglyceride level (178.6±99.7 vs. 89.9±38.3 mg/dL), the serum glucose level (101.2±21.3 vs. 89.8±6.8) were significantly greater in patients than controls. VFA was increased in gout patients compared to controls (115.8±27.0 vs. 97.7±20.2 cm2, P<0.001) and the prevalence of VFO was also higher in patients group (71.8% vs. 41.2%, P<0.001). There were significant correlations between VFA and the serum triglyceride level (Spearman's rho =0.274, P<0.001) and the serum glucose level (rho =0.324, P<0.001). In non-obese subgroup analysis (gout patients =38, healthy controls =150), VFA (98.7±19.3 vs. 91.0±16.7, P=0.016) and the frequency of VFO (47.4 vs. 27.3%, P=0.017) remained significantly higher in patients group. There was no difference in either BMI or the total fat mass between patients and controls in the non obese subgroup.
Conclusions VFO determined by BIA is more frequently observed in patients with primary gout compared to healthy controls, even in non-obese subgroup analysis and VFA correlated well with components of metabolic syndrome. Thus, it seems that VFO may properly represent metabolic derangement in both obese and non-obese patients with gout.
Disclosure of Interest None declared
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