Araştırma Makalesi
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Gut Hastalarında Biyokimyasal Parametrelerin ve Komorbiditelerin Önemi

Yıl 2022, Cilt: 19 Sayı: 3, 462 - 465, 27.12.2022
https://doi.org/10.35440/hutfd.1089861

Öz

Giriş: Gut hastalığı uzun süreli hiperüriseminin sonucu olarak eklem ve dokularda monosodyum ürat kristallerinin birikimi sonucu ortaya çıkan, akut artrit atakları ile karakterize inflamatuar bir hastalıktır. Bu çalışma ile gut tanısı konulan hastaların demografik verileri ve komorbid hastalıkları retrospektif olarak araştırılmıştır.
Gereç ve yöntem: Bu çalışma retrospektif olarak Ocak 2020-Aralık 2021 arasında Kahramanmaraş Necip Fazıl Şehir Hastanesi Romatoloji Kliniğinde yapıldı. Çalışmaya 18 yaş üzeri göre 2015 EULAR/ACR sınıflama kriterlerine göre gut tanısı alan hastalar dahil edildi.
Bulgular: Kliniğimizde değerlendirilen 110 hastanın 77 tanesi erkek (%70), 33 tanesi kadındı (%30).Hastaların yaş ortalaması 60.3 olarak bulundu. Eklem tutulumu en sık birinci metatars 89 hastada (%80.9) gözlendi. Komorbid hastalıklar değerlendirildiğinde en sık Diabetes mellitus 77 hastada (%70) gözlendi. Diğer komorbid hastalıklar Hipertansiyon 59 hastada (% 53.6), Kronik böbrek yetmezliği 49 hastada (%44.5), Hiperlipidemi 42 hastada (%38.2), Koroner arter hastalığı 35 hasta (%31.8), Serebrovasküler olay iki hastada (%1.8) gözlendi. Laboratuvar parametreleri ortalaması wbc:8268,Hgb:14,17 gr /dl, ürik asit: 7,79 mg/dl, sedimantasyon:19.7 mm/saat,CRP:8,5mg/l, Üre:41 mg/dl, kreatinin:1.2mg/dl bulundu. Medikal tedavi olarak kolşisin 80 hastada (%72.7), allopürinol 104 hastada (%94.5), febuksostat iki hastada (%1.8) kullanıldığı gözlendi. Ürik asit değeri 80 hastada (%72.7) hedef değerde olmadığı ,30 hastada hedef değerde (%27.3) gözlendi.
Tartışma-sonuç: Bu çalışmada gut hastalarının demografik verileri, komorbit hastalıkları ve medikal tedavi yanıtları değerlendirilmiştir. Bu bulgular literatür ile uyumlu bulunmuştur. Diabetes mellitus, Hipertansiyon, Koroner arter hastalığı, Kronik böbrek yetmezliği, obezite ve beslenme tarzı hastalık için başlıca risk faktörüdür. Gut hastalığın tedavisinde metabolik hastalıklar da göz önünde bulundurulmalıdır.

Destekleyen Kurum

YOK

Kaynakça

  • 1. Johnson RJ, Rideout BA. Uric acid and diet—insights into the epidemic of cardiovascular disease. New England Journal of Medicine. 2004;350(11):1071-3.
  • 2.Trifirò G, Morabito P, Cavagna L, Ferrajolo C, Pecchioli S, Simonetti M, et al. Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study. Annals of the rheumatic diseases. 2013;72(5):694-700.
  • 3.Bardin T, Bouée S, Clerson P, Chalès G, Flipo RM, Lioté F, et al. Prevalence of gout in the adult population of France. Arthritis care & research. 2016;68(2):261-6.
  • 4.Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Annals of the rheumatic diseases. 2015;74(4):661-7.
  • 5.Kuo C-F, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nature reviews rheumatology. 2015;11(11):649.
  • 6.A. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemiain the US general population: the National Health andNutrition Examination Survey 2007–2008. Arthritis Rheum 2011;63:3136–41.
  • 7.Roubenoff R. Gout and hyperuricemia. Rheumatic diseases clinics of North America. 1990;16(3):539-50.
  • 8.Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. New England Journal of Medicine. 2004;350(11):1093-103.
  • 9.Roubenoff R, Klag MJ, Mead LA, Liang K-Y, Seidler AJ, Hochberg MC. Incidence and risk factors for gout in white men. Jama. 1991;266(21):3004-7.
  • 10.Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Archives of internal medicine. 2005;165(7):742-8.
  • 11.Padang C, Muirden KD, Schumacher HR, Darmawan J, Nasution AR. Characteristics of chronic gout inNorthem Sulawesi, İndonesia. J Rheumatol. 2006 :33 (9); 1813-7
  • 12.Riedel AA, Nelson M, Wallace K, Joseph- Ridge N, Cleary M, Fam AG. Prevalance of comorbid conditions and among patients with gout and hyperuricemia in amanaged care setting. J Clin. Rheumatol. 2004 :10 (6); 308-314
  • 13. Rho YH, Choi SJ, Lee YH, Ji JD, Choi KM, Baik SH, Chung SH, Kim CG, Choe JY, Lee SW, Chung WT, Song GG. The prevalence ofmetabolic syndrome in patients with gout: a multicenter study. J Korean Med Sci. 2005; 20 (6): 1029-33
  • 14. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Archives of internal medicine. 2005;165(7):742-8.
  • 15.Chen J-H, Wen CP, Wu SB, Lan J-L, Tsai MK, Tai Y-P, et al. Attenuating the mortality risk of high serum uric acid: the role of physical activity underused. Annals of the rheumatic diseases. 2015;74(11):2034-42.
  • 16.Williams PT. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. The American journal of clinical nutrition. 2008;87(5):1480-7.
  • 17.Bhole V, de Vera M, Rahman MM, Krishnan E, Choi H. Epidemiology of gout in women: Fifty‐two–year followup of a prospective cohort. Arthritis & rheumatism. 2010;62(4):1069-76.
  • 18. Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M. Eligibility for and prescription of urate-lowering treatment in patients with incident gout in England. JAMA. 2014;312(24):2684-6.

The Importance of Biochemical Parameters and Comorbidity in Gut Patients

Yıl 2022, Cilt: 19 Sayı: 3, 462 - 465, 27.12.2022
https://doi.org/10.35440/hutfd.1089861

Öz

Abstract

Background: Gout is an inflammatory disease characterized by acute arthritis attacks, which occurs as a result of the accumulation of monosodium urate crystals in the joints and tissues as a result of long-term hyperuricemia. In this study, demographic data and comorbid diseases of patients diagnosed with gout were investigated retro-spectively.
Materials and Methods: This study was performed retrospectively in Kahramanmaraş Necip Fazıl City Hospital Rheumatology Clinic between January 2020 and December 2021. Patients over the age of 18 who were diag-nosed with gout according to the 2015 EULAR/ACR classification criteria were included in the study.
Results: In totals, 110 patients who diagnosed gout were included, 77 of whom males (70%), 33 of whom fe-males (30%).The mean age of the patients was 60.3. The most common joint involvement was observed in the first metatarsal and in 89 patients (80.9%). The most common comorbidity in patients with gout was Diabetes mellitus and evaluated in 77 patients (70%). The other comorbidities, Hypertension in 59 patients (53.6%), Chronic renal failure in 49 patients (44.5%), Hyperlipidemia in 42 patients (38.2%), coronary artery disease in 35 patients (31.8%), Cerebrovascular events was observed in two patients (1.8%). Mean laboratory parameters are as falloows: wbc: 8268, Hgb: 14.17 g / dl, uric acid: 7.79 mg / dl, sedimentation: 19.7 mm / hour, CRP: 8.5 mg / l, Urea: 41 mg / dl, creatinine :1.2mg/dl . As medical treatment, colchicine was used in 80 patients (72.7%), allopu-rinol was used in 104 patients (94.5%), and febuxostat was used in two patients (1.8%). The uric acid level was observed to be within the target value in 30 patients (27.3%) and not at the target value in 80 patients (72.7%).
Conclusions: In this study, demographic data, comorbid diseases and medical treatment responses of gout pa-tients were evaluated. These findings were found to be compatible with the literature. Diabetes mellitus, Hyper-tension, Coronary artery disease, Chronic renal failure, Obesity and diet are the main risk factors for the disease. Metabolic diseases should also be considered in the treatment of gout.

Keywords: Gout, Arthritis, Comorbidity

Kaynakça

  • 1. Johnson RJ, Rideout BA. Uric acid and diet—insights into the epidemic of cardiovascular disease. New England Journal of Medicine. 2004;350(11):1071-3.
  • 2.Trifirò G, Morabito P, Cavagna L, Ferrajolo C, Pecchioli S, Simonetti M, et al. Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study. Annals of the rheumatic diseases. 2013;72(5):694-700.
  • 3.Bardin T, Bouée S, Clerson P, Chalès G, Flipo RM, Lioté F, et al. Prevalence of gout in the adult population of France. Arthritis care & research. 2016;68(2):261-6.
  • 4.Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Annals of the rheumatic diseases. 2015;74(4):661-7.
  • 5.Kuo C-F, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nature reviews rheumatology. 2015;11(11):649.
  • 6.A. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemiain the US general population: the National Health andNutrition Examination Survey 2007–2008. Arthritis Rheum 2011;63:3136–41.
  • 7.Roubenoff R. Gout and hyperuricemia. Rheumatic diseases clinics of North America. 1990;16(3):539-50.
  • 8.Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. New England Journal of Medicine. 2004;350(11):1093-103.
  • 9.Roubenoff R, Klag MJ, Mead LA, Liang K-Y, Seidler AJ, Hochberg MC. Incidence and risk factors for gout in white men. Jama. 1991;266(21):3004-7.
  • 10.Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Archives of internal medicine. 2005;165(7):742-8.
  • 11.Padang C, Muirden KD, Schumacher HR, Darmawan J, Nasution AR. Characteristics of chronic gout inNorthem Sulawesi, İndonesia. J Rheumatol. 2006 :33 (9); 1813-7
  • 12.Riedel AA, Nelson M, Wallace K, Joseph- Ridge N, Cleary M, Fam AG. Prevalance of comorbid conditions and among patients with gout and hyperuricemia in amanaged care setting. J Clin. Rheumatol. 2004 :10 (6); 308-314
  • 13. Rho YH, Choi SJ, Lee YH, Ji JD, Choi KM, Baik SH, Chung SH, Kim CG, Choe JY, Lee SW, Chung WT, Song GG. The prevalence ofmetabolic syndrome in patients with gout: a multicenter study. J Korean Med Sci. 2005; 20 (6): 1029-33
  • 14. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Archives of internal medicine. 2005;165(7):742-8.
  • 15.Chen J-H, Wen CP, Wu SB, Lan J-L, Tsai MK, Tai Y-P, et al. Attenuating the mortality risk of high serum uric acid: the role of physical activity underused. Annals of the rheumatic diseases. 2015;74(11):2034-42.
  • 16.Williams PT. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. The American journal of clinical nutrition. 2008;87(5):1480-7.
  • 17.Bhole V, de Vera M, Rahman MM, Krishnan E, Choi H. Epidemiology of gout in women: Fifty‐two–year followup of a prospective cohort. Arthritis & rheumatism. 2010;62(4):1069-76.
  • 18. Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M. Eligibility for and prescription of urate-lowering treatment in patients with incident gout in England. JAMA. 2014;312(24):2684-6.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Muhammet Limon 0000-0002-5693-7885

Yayımlanma Tarihi 27 Aralık 2022
Gönderilme Tarihi 18 Mart 2022
Kabul Tarihi 25 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 19 Sayı: 3

Kaynak Göster

Vancouver Limon M. Gut Hastalarında Biyokimyasal Parametrelerin ve Komorbiditelerin Önemi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(3):462-5.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty