CLINICAL FEATURES OF GOUT IN WOMEN: THE RESULTS OF A COMPARATIVE STUDY
https://doi.org/10.14412/1995-4484-2014-178-182
Abstract
Objective. To identify the clinical features of gout in women.
Material and methods. A cross-sectional, comparative, multicenter study included 340 patients with gout (289 males and 51 females) who had been examined at V.A. Nasonova Research Institute of Rheumatology of the Russian Academy of Medical Sciences and at the Main Clinical Hospital of the Russian Interior Ministry Troops from 2002 to 2009. The main group was comprised of females; the comparison group consisted of males. The mean age of females was 52.3 ± 11.4 years; the mean age of males was 52.3 ± 10.4 years; the median duration of disease [25th; 75th per- centiles] was 4.8 [2.0; 7.6] years in females and 5.9 [3.3; 11,5] years in males (p=0.0053).
Results. In the group of females, the median duration of the first arthritis attack was 14 [10; 20] days; in the compari- son group, it was 10 [7; 14] days (p=0.0014). Chronic arthritis was observed in 66.7% of females and in 31.8% of males (p<0.0001); it progressed faster in females. The median number of the joints affected during the disease was 12 [7; 17] in females, and 7 [4; 12] in males (p=0.00025). Tophi developed earlier in females than in males (the median duration of disease, before they occurred, was 3 [2; 7] and 6 [4; 10], respectively; p=0.00036). The number of tophi was greater (the median 5 [3; 8] and 2 [1; 6], respectively; p=0.0066). Females were diagnosed with type 2 diabetes mellitus (DM) (p=0.021) and chronic kidney disease (p<0.0001) more often than males; a higher serum cholesterol level (p=0.022) was observed. Females received diuretics (57% vs. 20%; p<0.0001) more often than males; however, they consumed alcoholic beverages less frequently (57 and 20%; p<0.0001; 28 and 4%; p<0.0001; respectively).
Conclusion. In females, gout progression is more severe; females were diagnosed with type 2 diabetes mellitus and chronic kidney disease more frequently than males; they also had a higher cholesterol level. Females were more likely to administer diuretics and consume less alcohol.
About the Authors
M. S. EliseevRussian Federation
N. A. Chikalenkova
Russian Federation
V. G. Barskova
Russian Federation
References
1. Bhole V, de Vera M, Rahman MM, et al. Epidemiology of gout in women: Fifty-two-year followup of a prospective cohort. Arthritis Rheum. 2010 Apr;62(4):1069–76. DOI: http://dx.doi.org/10.1002/art.27338.
2. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyper- uricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011;63(10):3136–41. DOI: http://dx.doi.org/10.1002/art.30520.
3. Lally EV, Ho G, Kaplan SR. The clinical spectrum of gouty arthritis in women. Arch Intern Med. 1986;146(11):2221–5. DOI: http://dx.doi.org/10.1001/archinte.1986.00360230161022.
4. Елисеев МС, Чикаленкова НА, Денисов ИС, Барскова ВГ. Факторы риска подагры: половые различия. Научно- практическая ревматология. 2011;49(6):28–31. [Eliseyev MS, Chikalenkova NA, Denisov IS, Barskova BG. Risk factors for gout: Gender differences. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2011;49(6):28–31. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2011-516.
5. Meyers OL, Monteagudo FS. A comparison of gout in men and women. A 10-year experience. S Afr Med J. 1986;70(12):721–3.
6. De Souza AW, Fernandes V, Ferrari AJ. Female gout: clinical and laboratory features. J Rheumatol. 2005;32(11):2186–8.
7. Harrold LR, Yood RA, Mikuls TR, et al. Sex differences in gout epidemiology: evaluation and treatment. Ann Rheum Dis. 2006;65(10):1368–72. DOI: http://dx.doi.org/10.1136/ard.2006.051649.
8. Dirken-Heukensfeldt KJ, Teunissen TA, van de Lisdonk H, Lagro-Janssen AL. Clinical features of women with gout arthritis. A systematic review. Clin Rheumatol. 2010;29(6):575–82. DOI: http://dx.doi.org/10.1007/s10067-009-1362-1.
9. Puig JG, Michan AD, Jimenez ML, et al. Female gout. Clinical spectrum and uric acid metabolism. Arch Intern Med. 1991;51(4):726–32. DOI: http://dx.doi.org/10.1001/arch- inte.1991.00400040074016.
10. Garcia-Mendez S, Beas-Ixtlahuac E, Hernandez-Cuevas C, et al. Female gout: age and duration of the disease determine clinical presentation. J Clin Rheumatol. 2012;18(5):242–5. DOI: http://dx.doi.org/10.1097/RHU.0b013e3182611827.
11. Meyers OL, Monteagudo FS. A comparison of gout in men and women. A 10-year experience. S Afr Med J. 1986;70(12):721–3.
12. Park YB, Park YS, Song J, et al. Clinical manifestations of Korean female gouty patients. Clin Rheumatol. 2000;19(2):142–6. DOI: http://dx.doi.org/10.1007/s100670050033.
13. Deesomchok U, Tumrasvin T. A clinical comparison of females and males with gouty arthritis. J Med Assoc Thai. 1989;72(9):510–5.
14. Chang SJ, Chen CJ, Hung HP, et al. Community-based study in Taiwan aborigines concerning renal dysfunction in gout patients. Scand J Rheumatol. 2004;33(4):233–8. DOI: http://dx.doi.org/10.1080/03009740310004919.
15. 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;5(4):225–31.
16. De Vera MA, Rahman MM, Bhole V, et al. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann Rheum Dis. 2010;69(6):1162–4. DOI: http://dx.doi.org/10.1136/ard.2009.122770.
17. Lottmann K, Chen X, SchКdlich PK. Association between gout and all-cause as well as cardiovascular mortality: a systematic review. Curr Rheumatol Rep. 2012;14(2):195–203. DOI: http://dx.doi.org/10.1007/s11926-011-0234-2.
18. Елисеев МС, Денисов ИС, Барскова ВГ. Оценка выживаемости больных подагрой. Терапевтический архив. 2012;84(5):45–50. [Eliseev MS, Denisov IS, Barskova VG. Survival of gout patients. Terapevticheskii arkhiv. 2012;84(5):45–50. (In Russ.)]
19. Елисеев МС, Барскова ВГ. Нарушения углеводного обмена при подагре: частота выявления и клинические особенности. Терапевтический архив. 2010;82(5):50–4. [Eliseev MS, Barskova VG. Violations of a carbohydrate exchange at gout: fre- quency of identification and clinical features. Terapevticheskii arkhiv. 2010;82(5):50–4. (In Russ.)]
20. Hu M, Tomlinson B. Gender-dependent associations of uric acid levels with a polymorphism in SLC2A9 in Han Chinese patients. Scand J Rheumatol. 2012;41(2):161–3. DOI: http://dx.doi.org/10.3109/03009742.2011.637952.
21. Елисеев МС, Барскова ВГ. Метаболический синдром при подагре. Вестник РАМН. 2008;6:29–32. [Eliseev MS, Barskova VG. Metabolicheskii sindrom pri podagre [Metabolic syndrome at gout]. Vestnik RAMN. 2008;6:29–32.]
Review
For citations:
Eliseev M.S., Chikalenkova N.A., Barskova V.G. CLINICAL FEATURES OF GOUT IN WOMEN: THE RESULTS OF A COMPARATIVE STUDY. Rheumatology Science and Practice. 2014;52(2):178-182. (In Russ.) https://doi.org/10.14412/1995-4484-2014-178-182