Comorbid pathology in patients with hyperuricemia in the Khabarovsk region

Abstract

BACKGROUND: Uric acid can affect many metabolic processes in the human body. In recent decades, great importance has been given to increased levels of uric acid — hyperuricemia. Hyperuricemia has been proven to be an independent risk factor for the development of cardiovascular, renal and metabolic diseases, and not just their marker, as had previously ben considered.

AIM: To determine the incidence of hyperuricemia at the primary outpatient stage, as well as to assess the prevalence of comorbid pathology among patients with hyperuricemia in the Khabarovsk Territory.

MATERIALS AND METHODS: We analyzed 5261 medical records of the patients who applied for an initial outpatient appointment at the Clinical Diagnostic Center and the Viveya Consultative and Diagnostic Center in Khabarovsk from November 2022 to November 2023. From the total number of medical records 2428 patients had elevated level of uric acid in the blood.

RESULTS: Arterial hypertension (60.5%) was the most common pathology; obesity – the second (27.35%); diabetes mellitus type 2 was less common in the patients with hyperuricemia (17.75%), and nephrolithiasis was the least common pathology (7.91%).

CONCLUSIONS: A high prevalence of hyperuricemia among the population of the Khabarovsk Territory was revealed. Elevated levels of uric acid affect the development of comorbid pathology in the patients, in particular cardiovascular pathology. The results obtained during the study indicate a high prevalence of comorbid diseases in hyperuricemia with arterial hypertension being the most frequent.

Keywords

uric acid / hyperuricemia / arterial hypertension / comorbid diseases

References

[1] Borghi C, Rosei EA, Bardin T, et al. Serum uric acid and the risk of cardiovascular and renal disease. J Hypertens. 2015;33(9):1729–1741. doi: 10.1097/HJH.0000000000000701

[2] Borghi C., Rosei E.A., Bardin T., et al. Serum uric acid and the risk of cardiovascular and renal disease // J Hypertens. 2015. Vol. 33, N. 9. P. 1729–1741. doi: 10.1097/HJH.0000000000000701

[3] Johnson RJ, Kang DH, Feig D, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41(6):1183–1190. doi: 10.1161/01.HYP.0000069700.62727.C5

[4] Johnson R.J., Kang D.H., Feig D., et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? // Hypertension. 2003. Vol. 41, N. 6. P. 1183–1190. doi: 10.1161/01.HYP.0000069700.62727.C5

[5] Chazova IE, Zhernakova YuV, Kislyak OA, et al. Consensus on the management of patients with hyperuricemia and high cardiovascular risk: 2022. Systemic hypertension. 2022;19(1):5–22. EDN: HBLVVV doi: 10.38109/2075-082X-2022-1-5-22

[6] Чазова И.Е., Жернакова Ю.В., Кисляк О.А., и др. Консенсус по ведению пациентов с гиперурикемией и высоким сердечно-сосудистым риском: 2022 // Системные гипертензии. 2022. Т. 19, № 1. С. 5–22. EDN: HBLVVV doi: 10.38109/2075-082X-2022-1-5-22

[7] Shalnova SA, Deev AD, Artamonov GV, et al. Hyperuricemia and its correlates in the Russian population (results of ESSE-RF epidemiological study). Rational Pharmacotherapy in Cardiology. 2014;10(2):153–159. EDN: SCOUHN doi: 10.20996/1819-6446-2014-10-2-153-159

[8] Шальнова С.А., Деев А.Д., Артамонова Г.В. и др. Гиперурикемия и ее корреляты в Российской популяции (результаты эпидемиологического исследования ЭССЕ-РФ) // Рациональная фармакотерапия в кардиологии. 2014. Т. 10, № 2. С. 153–159. EDN: SCOUHN doi: 10.20996/1819-6446-2014-10-2-153-159

[9] Hui M, Carr A, Cameron S, et al. The British Society for Rheumatology Guideline for the Management of Gout. Rheumatology (Oxford). 2017;56(7):1246. doi: 10.1093/rheumatology/kex250

[10] Hui M., Carr A., Cameron S., et al. The British Society for Rheumatology Guideline for the Management of Gout // Rheumatology (Oxford). 2017. Vol. 56, N. 7. P. 1246. doi: 10.1093/rheumatology/kex250

[11] Borghi C, Domienik-Karlowicz J, Tykarski A, et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update. Cardiol J. 2021;28(1):1–14. doi: 10.5603/CJ.a2021.0001

[12] Borghi C., Domienik-Karlowicz J., Tykarski A., et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update // Cardiol J. 2021. Vol. 28, N. 1. P. 1–14. doi: 10.5603/CJ.a2021.0001

[13] Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953–2041. doi: 10.1097/HJH.0000000000001940

[14] Williams B., Mancia G., Spiering W., et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension // J Hypertens. 2018. Vol. 36, N. 10. P. 1953–2041. doi: 10.1097/HJH.0000000000001940

[15] Kobalava ZhD, Konradi AO, Nedogoda SV, et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020;25(3):149–218. EDN: TCRBRB doi: 10.15829/1560-4071-2020-3-3786

[16] Кобалава Ж.Д., Конради А.О., Недогода С.В., и др. Артериальная гипертензия у взрослых. Клинические рекомендации 2020 // Российский кардиологический журнал. 2020. Т. 25, № 3. С. 149–218. EDN: TCRBRB doi: 10.15829/1560-4071-2020-3-3786

[17] Sánchez-Lozada LG, Tapia E, Santamaría J, et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int. 2005;67(1):237–247. doi: 10.1111/j.1523-1755.2005.00074.x

[18] Sánchez-Lozada L.G., Tapia E., Santamaría J., et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats // Kidney Int. 2005. Vol. 67, N. 1. P. 237–247. doi: 10.1111/j.1523-1755.2005.00074.x

[19] Mazurov VI, Drapkina OM, Martynov AI, et al. Meta-analysis of observational cohort studies on the association of asymptomatic hyperuricemia with chronic kidney disease. Therapy. 2023;9(10):21–39. doi: 10.18565/therapy.2023.10.21-39

[20] Мазуров В.И., Драпкина О.М., Мартынов А.И., и др. Метаанализ наблюдательных когортных исследований о взаимосвязях бессимптомной гиперурикемии с хронической болезнью почек // Терапия. 2023. Т. 9, № 10. С. 21–39. doi: 10.18565/therapy.2023.10.21-39

[21] Nasonova VA, Barskova VG. Early diagnostic and treatment of gout — is scientifically based reguirements for improvement of labour and living prognosis of patients. Rheumatology Science and Practice. 2004;42(1):5–7. EDN: QCWYZP doi: 10.14412/1995-4484-2004-1374

[22] Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры — научно обоснованное требование улучшения трудового и жизненного прогноза больных // Научно-практическая ревматология. 2004. Т. 42, № 1. С. 5–7. EDN: QCWYZP doi: 10.14412/1995-4484-2004-1374

[23] Chen-Xu M, Yokose C, Rai S.K, et al. Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: The National Health and Nutrition Examination Survey, 2007–2016. Arthritis Rheumatol. 2019;71(6):991–999. doi: 10.1002/art.40807

[24] Chen-Xu M., Yokose C., Rai S.K., et al. Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: The National Health and Nutrition Examination Survey, 2007–2016 // Arthritis Rheumatol. 2019. Vol. 71, N. 6. P. 991–999. doi: 10.1002/art.40807

[25] Kumar AUA, Browne LD, Li X, et al. Temporal trends in hyperuricaemia in the Irish health system from 2006–2014: A cohort study. PLoS One. 2018;13(5):e0198197. doi: 10.1371/journal.pone.0198197

[26] Kumar A.U.A., Browne L.D., Li X., et al. Temporal trends in hyperuricaemia in the Irish health system from 2006–2014: A cohort study // PLoS One. 2018. Vol. 13, N. 5. P. e0198197. doi: 10.1371/journal.pone.0198197

[27] Sumpter NA, Saag KG, Reynolds RJ, Merriman TR. Comorbidities in gout and hyperuricemia: causality or epiphenomena? Curr Opin Rheumatol. 2020;32(2):126–133. doi: 10.1097/BOR.0000000000000691

[28] Sumpter N.A., Saag K.G., Reynolds R.J., Merriman T.R. Comorbidities in gout and hyperuricemia: causality or epiphenomena? // Curr Opin Rheumatol. 2020. Vol. 32, N. 2. P. 126–133. doi: 10.1097/BOR.0000000000000691

[29] Sandoval-Plata G, Nakafero G, Chakravorty M, et al. Association between serum urate, gout and comorbidities: a case-control study using data from the UK Biobank. Rheumatology (Oxford). 2021;60(7):3243–3251. doi: 10.1093/rheumatology/keaa773

[30] Sandoval-Plata G., Nakafero G., Chakravorty M., et al. Association between serum urate, gout and comorbidities: a case-control study using data from the UK Biobank // Rheumatology (Oxford). 2021. Vol. 60, N. 7. P. 3243–3251. doi: 10.1093/rheumatology/keaa773

[31] Mazurov VI, Sayganov SA, Bashkinov RA, et al. The effect of urate-lowering therapy on the course of chronic kidney disease in patients with osteoarthritis and asymptomatic hyperuricemia. Therapy. 2023;9(7):56–71. doi: 10.18565/therapy.2023.7.56-71

[32] Мазуров В.И., Сайганов С.А., Башкинов Р.А., и др. Влияние уратснижающей терапии на течение хронической болезни почек у пациентов с остеоартритом и бессимптомной гиперурикемией // Терапия. 2023. Т. 9, № 7. С. 56–71. doi: 10.18565/therapy.2023.7.56-71

[33] Mazurov VI, Sayganov SA, Martynov AI, et al. Impact of urate-lowering therapy on the course of chronic kidney disease in patients with asymptomatic hyperuricemia: a meta-analysis of randomized controlled trials. Herald of North-Western State Medical University named after I.I. Mechnikov. 2023;15(4):5–18. EDN: ESRPKU doi: 10.17816/mechnikov604850

[34] Мазуров В.И., Сайганов С.А., Мартынов А.И., и др. Влияние уратснижающей терапии на течение хронической болезни почек у пациентов с бессимптомной гиперурикемией: метаанализ рандомизированных контролируемых исследований // Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2023. Т. 15, № 4. С. 5–18. EDN: ESRPKU doi: 10.17816/mechnikov604850

[35] Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52(1):283–289. doi: 10.1002/art.20761

[36] Choi H.K., Liu S., Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey // Arthritis Rheum. 2005. Vol. 52, N. 1. P. 283–289. doi: 10.1002/art.20761

[37] Li L, Yang C, Zhao Y, et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014;15(1):122. doi: 10.1186/1471-2369-15-122

[38] Li L., Yang C., Zhao Y., et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies // BMC Nephrol. 2014. Vol. 15, N. 1. P. 122. doi: 10.1186/1471-2369-15-122

[39] Singh JA, Gaffo A. Gout epidemiology and comorbidities. Semin Arthritis Rheum. 2020;50(3S):S11–S16. doi: 10.1016/j.semarthrit.2020.04.008

[40] Singh J.A., Gaffo A. Gout epidemiology and comorbidities // Semin Arthritis Rheum. 2020. Vol. 50, N. 3S. P. S11–S16. doi: 10.1016/j.semarthrit.2020.04.008

[41] Mazurov VI, Petrova MS, Gaidukova IZ, et al. Features of gouty arthritis according to the St. Petersburg City Gout Registry 2016–2018. Therapy. 2019;6(32):27–34. doi: 10.18565/therapy.2019.6.27-34

[42] Мазуров В.И., Петрова М.С., Гайдукова И.З., и др. Коморбидность при подагрическом артрите по данным Санкт-Петербургского городского регистра подагры 2016–2018 гг. // Терапия. 2019. Т. 6, № 32. С. 27–34. doi: 10.18565/therapy.2019.6.27-34

[43] 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 Rheum. 2011;63(10):3136–3141. doi: 10.1002/art.30520

[44] Zhu Y., Pandya B.J., Choi H.K. Prevalence of gout and hyperuricemia in the US general population. The National Health and Nutrition Examination Survey 2007–2008 // Arthritis Rheum. 2011. Vol. 63, N. 10. P. 3136–3141. doi: 10.1002/art.30520

[45] Mazurov VI, Gaidukova IZ, Bashkinov RA, et al. Asymptomatic hyperuricemia impact on the comorbid pathology course in patients with osteoarthritis and the possibility of its correction. RMJ. 2021;29(6):56–62. EDN: GDWNGZ

[46] Мазуров В.И., Гайдукова И.З., Башкинов Р.А., и др. Влияние бессимптомной гиперурикемии на течение коморбидной патологии у пациентов с остеоартритом и возможности ее коррекции // РМЖ. 2021. Т. 29, № 6. С. 56–62. EDN: GDWNGZ

[47] Mazurov VI, Bashkinov RA, Fonturenko AYu, et al. Features of the course of rheumatoid arthritis and osteoarthritis in patients with asymptomatic hyperuricemia. Herald of North-Western State Medical University named after I.I. Mechnikov. 2020;12(3):63–72. EDN: XQZWVY doi: 10.17816/mechnikov44234

[48] Мазуров В.И., Башкинов Р.А., Фонтуренко А.Ю., и др. Особенности течения ревматоидного артрита и остеоартрита у пациентов с бессимптомной гиперурикемией // Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2020. Т. 12, № 3. С. 63–72. EDN: XQZWVY doi: 10.17816/mechnikov44234

[49] Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension. 2003;42:247–252. doi: 10.1161/01.HYP.0000085858.66548.59

[50] Feig D.I., Johnson R.J. Hyperuricemia in childhood primary hypertension // Hypertension. 2003. Vol. 42. P. 247–252. doi: 10.1161/01.HYP.0000085858.66548.59

[51] Yarovoy SK, Maksudov RR. Purine metabolism disturbances in the urological practice. Experimental and clinical urology. 2013;(3):88–93. EDN: REDDLV

[52] Яровой С.К., Максудов Р.Р. Нарушения обмена пуринов в практике врачауролога // Экспериментальная и клиническая урология. 2013. № 3. С. 88–93. EDN: REDDLV

[53] Zuo T, Liu X, Jiang L, et al. Hyperuricemia and coronary heart disease mortality: a meta-analysis of prospective cohort studies. BMC Cardiovasc Disord. 2016;16(1):207. doi: 10.1186/s12872-016-0379-z

[54] Zuo T., Liu X., Jiang L., et al. Hyperuricemia and coronary heart disease mortality: a meta-analysis of prospective cohort studies // BMC Cardiovasc Disord. 2016. Vol. 16, N. 1. P. 207. doi: 10.1186/s12872-016-0379-z

[55] Bos MJ, Koudstaal PJ, Hofman A, et al. Uric acid is a risk factor for myocardial infarction and stroke: The Rotterdam Study. Stroke. 2006;37(6):1503–1507. doi: 10.1161/01.STR.0000221716.55088.d4

[56] Bos M.J., Koudstaal P.J., Hofman A., et al. Uric acid is a risk factor for myocardial infarction and stroke: The Rotterdam Study // Stroke. 2006. Vol. 37, N. 6. P. 1503–1507. doi: 10.1161/01.STR.0000221716.55088.d4

[57] Drapkina OM, Mazurov VI, Martynov AI, et al. “Focus on hyperuricemia.” Resolution of the expert council. Cardiovascular therapy and prevention. 2023;22(4):77–84. EDN: KRCKAU doi: 10.15829/1728-8800-2023-3564

[58] Драпкина О.М., Мазуров В.И., Мартынов А.И., и др. «В фокусе гиперурикемия». Резолюция совета экспертов // Кардиоваскулярная терапия и профилактика. 2023. Т. 22, № 4. С. 77–84. EDN: KRCKAU doi: 10.15829/1728-8800-2023-3564

[59] Chazova IE, Zhernakova JuV, Kisliak OA, et al. Consensus on patients with hyperuricemia and high cardiovascular risk treatment. Systemic Hypertension. 2019;16(4):8–21. EDN: HSKPCZ doi: 10.26442/2075082X.2019.4.190686

[60] Чазова И.Е., Жернакова Ю.В., Кисляк О.А., и др. Консенсус по ведению пациентов с гиперурикемией и высоким сердечно-сосудистым риском // Системные гипертензии. 2019. Т. 16, № 4. С. 8–21. EDN: HSKPCZ doi: 10.26442/2075082X.2019.4.190686

[61] Zhilyaev EV. Changes in strategies for gout treatment. Difficult patient. 2017;15(10–11):1–19.

[62] Жиляев Е.В. Изменения в подходах к лечению подагры // Трудный пациент. 2017. Т. 15, № 10–11. С. 1–19.

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