Background Atherogenic serum lipid profile is prevalent in gouty patients.Recently conducted in vitro,in vivo and clinical studies of gout have evidenced proinflammatory effects of LDL-C and antiinflammatory properties of HDL-C (1–3).
Objectives To investigate if atherogenic serum lipid profile in gouty patients predicts gout activity.
Methods A total number of 69 patients (97,1% male) were divided into two groups with regard to the frequency of their gouty flares: group 1 (up to 1 flare per year) and group 2 (2 or more flares per year, with the maximum flare number of 20). Logistic regression model was used to identify the set of metabolic items able to predict frequent flares in gout. The following variables were included in the model: total cholesterol level (border set up at 5,2 mmol/L), HDL cholesterol level (1,03 mmol/L for men and 1,3 mmol/L for women), LDL cholesterol level (3,37 mmol/L) triglicerydes (1,68 mmol/L) and serum uric acid (359 mmol/L). The fit of the selected model to the actual outcome was determined with a set of goodness of fit tests. All analyses were carried out using statistical program SPSS 20.0.
Results Logistic model was acceptable, by showing 74% of correctly predicted cases in a classification table with a cut off value of p=0.5. Hosmer and Lemeshow goodness of fit test was found to be nonsignificant (p=0,881), suggesting that model fit to data well. Two additional goodness-of-fit tests which confirmed those results were Cox and Snell R2 (p=0,195) and Nagelkerke R2 (p=0,275). According to the logistic regression model, the only significant predictor of the gouty flares frequency in patients with gout was the high LDL cholesterol level (p=0,008).
Conclusions More frequent flares in patients with gout were predicted by the higher LDL cholesterol level only. Surprisingly, gouty flares were not predicted by serum uric acid level, as it was commonly thought. HDL cholesterol level, total cholesterol level and level of triglycerides were not found to be the predictors of the frequent gout attacks.
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Disclosure of Interest None declared