rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2020-701-707rsp-2971Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHРаспространенность и факторы риска развития артериальной гипертонии у пациентов с подагройPrevalence and risk f actors influencing the development of arterial hypertension in patients with a gouthttps://orcid.org/0000-0002-1729-4610МаркеловаЕ. И.MarkelovaE. I.

Маркелова Евгения Иннокентьевна

115522, Москва, Каширское шоссе, 34А

Eugenia Markelova

115522, Moscow, Kashirskoe Highway, 34A

evgenia-i.m@yandex.ruhttps://orcid.org/0000-0003-1191-5831ЕлисеевМ. С.EliseevM. S.

115522, Москва, Каширское шоссе, 34А

Maxim S. Eliseev

115522, Moscow, Kashirskoe Highway, 34A

https://orcid.org/0000-0001-5793-4689ПопковаТ. В.PopkovaT. V.

115522, Москва, Каширское шоссе, 34А

Tatiana V. Popkova

115522, Moscow, Kashirskoe Highway, 34A

https://orcid.org/0000-0002-6354-7244ИльиныхЕ. В.IlinyhE. V.

115522, Москва, Каширское шоссе, 34А

Ekateriina V. Ilinyh

115522, Moscow, Kashirskoe Highway, 34A

https://orcid.org/0000-0002-4285-0869ГлуховаС. И.GlukhovaS. I.

115522, Москва, Каширское шоссе, 34А

Sveetlana I. Glukhova

115522, Moscow, Kashirskoe Highway, 34A

БарсковаВ. Г.BarskovaV. G.

115522, Москва, Каширское шоссе, 34А

115522, Moscow, Kashirskoe Highway, 34A

ФГБНУ Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202014012021586701707Copyright © Маркелова Е.И., Елисеев М.С., Попкова Т.В., Ильиных Е.В., Глухова С.И., Барскова В.Г., 20212021Маркелова Е.И., Елисеев М.С., Попкова Т.В., Ильиных Е.В., Глухова С.И., Барскова В.Г.Markelova E.I., Eliseev M.S., Popkova T.V., Ilinyh E.V., Glukhova S.I., Barskova V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2971

Цель исследования — оценить влияние различных факторов риска на развитие артериальной гипертонии у больных подагрой.

Материал и методы

Материал и методы. В исследование включено 286 мужчин с диагнозом подагра, соответствующим критериям S.L. Wallace. Всем пациентам проведено стандартное клиническое обследование, определялся уровень общего холестерина, холестерина липопротеинов низкой плотности, триглицеридов, холестерина липопротеинов высокой плотности, С-реактивного белка, мочевой кислоты, креатинина. Оценивались факторы риска сердечно-сосудистых заболеваний: отягощенный семейный анамнез по сердечно-сосудистым заболеваниям, индекс массы тела (ИМТ), наличие абдоминального ожирения, сахарного диабета, курение, злоупотребление алкоголем, малоподвижный образ жизни. Рассчитывалось отношение шансов (ОШ) развития артериальной гипертонии у больных подагрой и 95% доверительный интервал (ДИ).

Результаты

Результаты. В зависимости от наличия артериальной гипертонии больные были разделены на две группы: в первую вошли 244 (85%) пациента с артериальной гипертонией, во вторую — 42 (15%) пациента без данного заболевания. В первой группе пациенты были старше, имели большую длительность подагры и большее количество пораженных суставов, чем во второй (медиана возраста составила соответственно 52,3 [44,5; 61,1] и 41,9 [38,3; 50,1] года (р <0,01), длительности болезни - 6,7 [3,9; 13,7] и 4,5 [3; 7,9] года (р <0,01), суставного счета — 8 [4; 12] и 5 [3; 9] (р <0,01)). В I группе по сравнению со II чаще встречался отягощенный семейный анамнез раннего развития артериальной гипертонии (68,3 и 48,8% соответственно), абдоминальное ожирение (55,3 и 33,3%), нефролитиаз (71 и 54,7%), внутрикостные тофусы (48 и 21%), (р<0.05). Также у больных I группы был выше индекс массы тела (30,2 [27,4; 33,1] и 27,9 [26,3; 30,5] кг/м2) и уровень СРБ (12,7 [5,84; 19,2] и 7,8 [3,7; 16,4] мг/л), (р<0,05 во всех случаях). Не выявлено различий сывороточного уровня мочевой кислоты, липидного профиля, частоты курения и сахарного диабета.

Влияние факторов риска оценивалось с помощью вычисления отношения шансов (ОШ) и графиков форест-плот. У больных подагрой выявлена связь с развитием артериальной гипертонии следующих параметров: абдоминального ожирения (ОШ - 5,54, 95% ДИ: 2,25-13,61), ожирения по ИМТ (ОШ - 5,87; 95% ДИ: 1,86-18,52), семейного анамнеза артериальной гипертонии (ОШ - 2,71; 95% ДИ: 1,35-5,43), длительности подагры более 10 лет (ОШ - 2,61; 95% ДИ: 1,32-5,15), возраста дебюта подагры старше 35 лет (ОШ - 3,04; 95% ДИ: 1,51-6,13), внутрикостных тофусов (ОШ - 3,17; 95% ДИ: 1,43-7,01), хронической болезни почек в анамнезе (ОШ - 18,89; 95% ДИ: 1,14-312,95), сывороточного уровня СРБ (ОШ - 2,29; 95% ДИ: 1,114,73).

Заключение

Заключение. У большинства больных подагрой (85%) была выявлена артериальная гипертония. Обнаружена связь ожирения, отягощенного семейного анамнеза раннего развития артериальной гипертонии, длительности подагры более 10 лет, возраста старше 35 лет, наличия внутрикостных тофусов, сывороточного уровня СРБ с увеличением риска развития артериальной гипертонии у больных подагрой.

Background

Background. Cardiovascular diseases (CVD) is the leading cause of death for gout. Arterial hypertension is a proven CVD risk factor (CVD-RF).

Objective

Objective. To assess the factors influencing on development of an arterial hypertension in patients with a gout. Subjects and methods. 286 male patients fulfilling Wallace proposed criteria for gout were included in the study: age 51.2 [42.8; 59.4] years, disease duration - 6.2 [3.8; 12.1] years, number of joints involved during disease course - 7 [4; 12], subcutaneous tophi - in 35% of patients, intraosseous tophi - in 44%, nephrolithiasis - in 69%, abdominal obesity - in 71%. All patients underwent standard clinical examination, C-reactive protein (CRP), total cholesterol, triglycerides, low and high density lipoproteins, serum uric acid, serum creatinine, smoking, family history of arterial hypertension, body mass index (BMI), diabetes mellitus was performed by standard procedure. We estimated the adjusted odds ratio (OR) and 95% confidence interval (95% CI).

Results

Results. There were two groups of patients with arterial hypertension diagnosed on clinical data: group 1 (with arterial hypertension) - 244 (85%) patients, group 2 (without arterial hypertension) - 42 (15%) patients. The group 1 patients were older (52.3 [44.5; 61.1] vs 41.9 [38.3; 50.1] years old), had longer duration of gout (6.7 [3.9; 13.7] vs 4.5 [3; 7.9]), a higher number of joints involved during disease course (8 [4; 12] vs 5 [3; 9]). The frequency of family history of arterial hypertension (68.3 vs 48.8%), abdominal obesity (55.3 vs 33.3%), nephrolithiasis (71 vs 54.7%), intraosseous tophi (48 vs 21%) was higher in group 1 as compared with group 2, р<0,05. BMI and CRP level was higher in group 1 compared with group 2: 30.2 [27.4; 33.1] vs 27.9 [26.3; 30.5] kg/m2, and 12.7 [5.84; 19.2] vs 7.8 [3.7; 16.4] mg/l, respectively, p<0.05. We did not find differences of lipid profile, serum uric acid, and serum creatinine level in groups 1 and 2. We also did not find differences the frequency of smoking, diabetes mellitus, subcutaneous tophi in both groups.

Abdominal obesity (OR - 1.247; 95% CI: 1.063-1.462), family history of arterial hypertension (OR - 2.8; 95% CI: 1.5-5.4), disease duration more than 10 years (OR - 4.5; 95% CI: 1.1-19.4), intraosseous tophi (OR - 3.0; 95% CI: 1.4-6.4), increased the risk for arterial hypertension in patients with a gout.

Conclusion

Conclusion. The majority (85%) of patients with gout had arterial hypertension. Abdominal obesity, family history of arterial hypertension, disease duration more than 10 years, intraosseous tophi were associated with an increased risk of arterial hypertension in patients with a gout.

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The authors declare that there are no conflicts of interest present.