Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Gout Linked with Impaired Arterial Responsiveness

Clin Rheumatol; ePub 2018 Feb 15; Krasnokutsky, et al

Compared with healthy controls, subjects with gout have reduced arterial function, according to a recent study. Individual comorbidities are insufficient to account for differences between gout and control groups, but multiple comorbidities may collectively contribute to impairment in endothelium-dependent arterial responsiveness. Endothelial impairment is also related to serum rate (sUA) and high-sensitivity C-reactive protein (hsCRP), markers of gout severity and inflammation, respectively. Researchers conducted a cross-sectional study of untreated gout subjects (n=34) and non-gout healthy controls (n=64). High-resolution dynamic ultrasound-measured flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) assessed endothelium-dependent and endothelium-independent arterial responsiveness, respectively. sUA and hsCRP were measured in the gout group, and correlated with FMD and NMD responses. They found:

  • Both FMD and NMD were impaired in the gout vs control group.
  • Stratification for individual comorbidities suggested that no single risk factor accounted for impaired FMD/NMD in the gout subjects.
  • However, the degree of association between gout and FMD, but not NMD impairment, was dampened after multivariable adjustment.
  • Within the gout group, there was an inverse correlation between FMD and sUA, and between FMD and hsCRP, but not between NMD and sUA or hsCRP.

Citation:

Krasnokutsky S, Romero AG, Bang D, et al. Impaired arterial responsiveness in untreated gout patients compared with healthy non-gout controls: association with serum urate and C-reactive protein. [Published online ahead of print February 15, 2018]. Clin Rheumatol. doi:10.1007/s10067-018-4029-y.

This Week's Must Reads

Inverse U-Shaped Link Between CRP, Systolic BP in RA, Arthritis Res Ther; 2018 Jun 1; Yu, Kim, Vanni, et al

Exercise Linked with Protective CV Risk in RA , J Clin Rheumatol; 2018 ePub May 25; Byram, et al

No Link Between Coffee Consumption and Incident RA, J Clin Rheumatol; ePub 2018 Apr 19; Lamichhane, et al

PROMIS Forms Capture Fatigue Experience in RA, Qual Life Res; ePub 2018 May 24; Bartlett, et al

MBDA Score Independently Predictive of Relapsing RA, PLoS One; ePub 2018 May 23; Moghadam, et al

Must Reads in Gout

Statin Use Linked with Lower Mortality in Gout, Semin Arthritis Rheum; ePub 2018 Mar 17; Keller, et al

Gout Linked with Impaired Arterial Responsiveness, Clin Rheumatol; ePub 2018 Feb 15; Krasnokutsky, et al

Gout Management Program Improved Outcomes, Arthritis Care Res; ePub 2018 Feb 13; Bulbin, et al

Incidence of Gout Has More than Doubled in US, J Rheumatol; ePub 2017 Dec 15; Elfishawi, et al

Gout Self-Management in African American Veterans, Arthritis Care Res; ePub 2017 Sep 26; Singh, Herbey, et al