rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2011-516rsp-654Research ArticleСтатьиArticlesФакторы риска подагры: половые различияRisk factors for gout: Gender differencesEliseyevMaxim SergeyevichEliseyevMaxim Sergeyevichelicmax@rambler.ruChikalenkovaN AChikalenkovaN A-ДенисовИ. С.DenisovI S-BarskovaB GBarskovaB G-201115122011496№6 (2011)2831Copyright © Eliseyev M.S., Chikalenkova N.A., Денисов И.С., Barskova B.G., 20112011Eliseyev M.S., Chikalenkova N.A., Денисов И.С., Barskova B.G.Eliseyev M.S., Chikalenkova N.A., Denisov I.S., Barskova B.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/654

Цель – сравнительная оценка факторов риска развития заболевания у больных подагрой мужчин и женщин. Материал и методы. В исследование включено 340 больных подагрой (289 мужчин и 51 женщина), обследованных в период с 2002 по 2009 г. Диагноз соответствовал критериям S.L. Wallace. Средний возраст женщин составил 52,3±11,4 года, мужчин – 52,3±10,4 года. Основную группу составили больные подагрой женщины, группу сравнения – больные подагрой мужчины. Все больные были анкетированы с целью выявления факторов риска подагры: предшествующего дебюту подагры регулярного приема диуретиков, алкогольных напитков, наличия артериальной гипертензии (АГ), у женщин – менопаузы. Результаты. О предшествующем подагре приеме диуретиков сообщили 57% женщин и 19,7% мужчин (p<0,00001). У всех муж чин они назначались по медицинским показаниям, 10 из 29 женщин принимали диуретики для снижения массы тела. Более 2 раз в неделю принимали алкоголь 17,6% женщин и 33,6% мужчин (p=0,032). Медиана потребляемого в неделю алкоголя у женщин составила 2 [1; 4] условные единицы (у. е.), у мужчин – 4 [2; 10] у. е. (p=0,002). Предшествующая дебюту подагры АГ выявлена у 30 (59%) женщин и 136 (47%) мужчин (p=0,13). Развитие менопаузы до дебюта подагры отмечено у 26 (51%) женщин. Заключение. Среди возможных причин развития подагры у женщин чаще, чем у мужчин, выявляется прием диуретиков, причем в 1/3 случаев женщины принимают их необоснованно. Женщины реже и в меньшем количестве принимают алкоголь, но частота приема ими алкогольных напитков ассоциируется с меньшим возрастом дебюта подагры. При ранней менопаузе или аменорее по дагра чаще дебютирует в молодом возрасте. АГ и у женщин (59%), и у мужчин (47%) – частый фактор риска развития подагры.

Objective: to comparatively assess risk factors for gout in male and female patients with this condition. Subjects and methods. The study enrolled 340 gouty patients (289 men and 51 women) examined in the period 2002 to 2009. The diagno sis corresponded to the criteria developed by S.L. Wallace. The mean age was 52.3±11.4 years for the women and 52.3±10.4 years for the men. The study group included female patients with gout and a comparison group comprised male patients with this condition. All the patients were interviewed using a questionnaire to identify risk factors for gout: the regular use of diuretics or alcoholic beverages before the onset of this disease, the presence of arterial hypertension (AH), and menopause in women. Results. The intake of diuretics before gout was reported by 57% of the women and 19.7% of the men (p < 0.00001). The drugs were given to all the men according to medical indications; 10 of 29 women took diuretics to lose weight. Alcohol was consumed more than twice week ly by 17.6% of the women and 33.6% of the men (p = 0.032). The median weekly alcohol consumption was 2 (range 1-4) conventional units (CU) in the women and 4 (range 2-10) CU in the men (p = 0.002). AH occurring the onset of gout was found in 30 (59%) women and 136 (47%) men (p = 0.13). Menopause developing prior to the onset of gout was noted in 26 (51%) women. Conclusion. Among possible causes of gout, the use of diuretics is more common in the women than in the men, moreover, the former take them unfairly in one third of cases. The women consume alcohol less frequently and in smaller quantities, but the rate of female intake of alcoholic beverages is associated with younger age at the onset of gout. In early menopause or amenorrhea, gout more frequently occurs at a young age. AH is a common risk factor for gout in both the women (59%) and the men (47%).

подаграфакторы рискаполовой диморфизмgoutrisk factorssexual dimorphismReferences<div><p>Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры – научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч-практич ревматол 2004;1:5–7.</p><p>Arromdee E., Michet C.J., Crowson C.S., et al. Epidemiology of gout: is the incidence rising? J Rheumatol 2002;29:2403–6.</p><p>Kramer H.M., Curhan G. The association between gout and nephrolotiasis: the National and Nutrition Examination Survey III, 1988-1994. Am J Kidney Dis 2002;40:37–42.</p><p>Agudelo C., Wise C. Crystal-associated arthritis. Clin Geriatr Med 1998;14:495–513.</p><p>Lally E.V., Ho G., Kaplan S.R. The clinical spectrum of gouty arthritis in women. Arch Intern Med 1986;146(11):2221–5.</p><p>Sumino H., Ichikawa S., Kanda T. et al. Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia. Lancet 1999;354:650.</p><p>Nicholls A., Snaith M.L., ScottJ.T. Effect of estrogen therapy on plasma and urinary levels of uric acid. BMJ 1973;1:449–51.</p><p>Harrold L.R., Yood R., Mikuls T.R. et al. Sex differences in gout epidemiology, evaluation and treatment. Ann Rheum Dis 2006;65(10):1368–72.</p><p>Wallace S.L., Robinson H., Masi A.T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthr Rheum 1977;20:895–900.</p><p>Puig J.G., Michan A.D., Jimenez M.L. et al. Female gout. Clinical spectrum and uric acid metabolism. Arch Intern Med 1991;51(4):726–32.</p><p>Reyes D., Lew S.Q., KimmelP.L. Gender differences in hypertension and kidney disease. Med Clin North Am 2005;89:613–30.</p><p>Top 200 generic drugs by units in 2007. Drug Topics Web site. http://drugtopics.modernmedicine.com/dru gtopics/data/articlestandard//drugtopics/072008/491181/article.pdf. Accessed January 3; 2008.</p><p>Drum D.E., Goldman P.A., JankowskiC.B. Elevation of serum uric acid as a clue to alcohol abuse. Arch Intern Med 1981;141:477–9.</p><p>Meyers O.L., Monteagudo F.S. A comparison of gout in men and women. A 10year experience. S Afr Med J 1986;70(12):721–3.</p><p>Souza A.W., Fernandes V., FerrariA.J. Female gout: clinical and laboratory features. J Rheumatol 2005;32(11):2186–8.</p><p>Tikly M., Bellingan A., Lincoln D., Russell A. Risk factors for gout: a hospital-based study in urban black South Africans. Rev Rhum Engl Ed 1998;65(4):225–31.</p><p>Mikkelsen W.M., Dodge H.J., Valkenburg H. The distribution of serum uric acid values in a population unselected as to gout or hyperuricemia: Tecumseh, Michigan, 1959–1960. Am J Med 1965;39:242–51.</p><p>Yahyaoui R., Esteva I., Haro-Mora J.J. et al. Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons. Clin Endocrinol Metab 2008;93:230–3.</p><p>Hak A.E., Choi H.K. Menopause, postmenopausal hormone use and serum uric acid levels in US women – The Third National Health and Nutrition Examination Survey. Arthr Res Ther 2008;10(5):116.</p><p>Choi H.K., Curhan G. Beer, liquor, wine and serum uric acid level – the Third National Health and Nutrition Examination Survey. Arthr Rheum 2004;51(6):1023–9.</p><p>Brandstatter A., Kleichl S., Kollerits B. et al. Sex-specific association of the putative fructose transporter SLC2A9 variants with uric acid levels is modified by BMI. Diabetes Care 2008;31(8):1662–7.</p></div><br /><div><p>Насонова В.А., Барскова В.Г. Ранние диагностика и лечение подагры – научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч-практич ревматол 2004;1:5–7.</p><p>Arromdee E., Michet C.J., Crowson C.S., et al. Epidemiology of gout: is the incidence rising? J Rheumatol 2002;29:2403–6.</p><p>Kramer H.M., Curhan G. The association between gout and nephrolotiasis: the National and Nutrition Examination Survey III, 1988-1994. Am J Kidney Dis 2002;40:37–42.</p><p>Agudelo C., Wise C. Crystal-associated arthritis. Clin Geriatr Med 1998;14:495–513.</p><p>Lally E.V., Ho G., Kaplan S.R. The clinical spectrum of gouty arthritis in women. Arch Intern Med 1986;146(11):2221–5.</p><p>Sumino H., Ichikawa S., Kanda T. et al. Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia. Lancet 1999;354:650.</p><p>Nicholls A., Snaith M.L., ScottJ.T. Effect of estrogen therapy on plasma and urinary levels of uric acid. BMJ 1973;1:449–51.</p><p>Harrold L.R., Yood R., Mikuls T.R. et al. Sex differences in gout epidemiology, evaluation and treatment. Ann Rheum Dis 2006;65(10):1368–72.</p><p>Wallace S.L., Robinson H., Masi A.T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthr Rheum 1977;20:895–900.</p><p>Puig J.G., Michan A.D., Jimenez M.L. et al. Female gout. Clinical spectrum and uric acid metabolism. Arch Intern Med 1991;51(4):726–32.</p><p>Reyes D., Lew S.Q., KimmelP.L. Gender differences in hypertension and kidney disease. Med Clin North Am 2005;89:613–30.</p><p>Top 200 generic drugs by units in 2007. Drug Topics Web site. http://drugtopics.modernmedicine.com/dru gtopics/data/articlestandard//drugtopics/072008/491181/article.pdf. Accessed January 3; 2008.</p><p>Drum D.E., Goldman P.A., JankowskiC.B. Elevation of serum uric acid as a clue to alcohol abuse. Arch Intern Med 1981;141:477–9.</p><p>Meyers O.L., Monteagudo F.S. A comparison of gout in men and women. A 10year experience. S Afr Med J 1986;70(12):721–3.</p><p>Souza A.W., Fernandes V., FerrariA.J. Female gout: clinical and laboratory features. J Rheumatol 2005;32(11):2186–8.</p><p>Tikly M., Bellingan A., Lincoln D., Russell A. Risk factors for gout: a hospital-based study in urban black South Africans. Rev Rhum Engl Ed 1998;65(4):225–31.</p><p>Mikkelsen W.M., Dodge H.J., Valkenburg H. The distribution of serum uric acid values in a population unselected as to gout or hyperuricemia: Tecumseh, Michigan, 1959–1960. Am J Med 1965;39:242–51.</p><p>Yahyaoui R., Esteva I., Haro-Mora J.J. et al. Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons. Clin Endocrinol Metab 2008;93:230–3.</p><p>Hak A.E., Choi H.K. Menopause, postmenopausal hormone use and serum uric acid levels in US women – The Third National Health and Nutrition Examination Survey. Arthr Res Ther 2008;10(5):116.</p><p>Choi H.K., Curhan G. Beer, liquor, wine and serum uric acid level – the Third National Health and Nutrition Examination Survey. Arthr Rheum 2004;51(6):1023–9.</p><p>Brandstatter A., Kleichl S., Kollerits B. et al. Sex-specific association of the putative fructose transporter SLC2A9 variants with uric acid levels is modified by BMI. Diabetes Care 2008;31(8):1662–7.</p></div><br />

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