Nabieva D.A.1, Khidoyatova M.R.2, Agzamova G.S.3, Abduazizova N.X.4, Matchanov S.X.5,
Midasov M.M.6, Shiranova Sh.A.7
Abstract
Evaluation of the correlation of immunological and biochemical values with clinical manifestations of gout, as well as the role of hyperuricemia in comorbid states is important for the search for therapeutic targets.
Objective: to investigate the relationship between indexes of dyslipidemia and immunological changes in patients with tophaceous gout and asymptomatic hyperuricemia.
Patients and methods. The study included 85 male patients: 1st group – 49 patients with primary chronic gout according to Wallace S.L. criteria, 2nd (control) group – 36 patients with asymptomatic hyperuricemia. The levels of uric acid (UA), C-reactive protein (CRP), fasting glycemia, lipid profile – total cholesterol (TC), triglycerides (TG), high-density (HDL), low density (LDL), very low density (VLDL) lipoproteins, atherogenic ratio (AR); cytokine concentrations: interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-4, IL-6, IL-8, IL-10 and IL-18 in the blood serum using enzyme-linked immunosorbent assay.
Results. UA values positively correlated with the number of affected joints (r=0.64, p=0.058), presence of tophi (r=0.73, p=0.042), glycemic level (r=0.74; p=0.038). An increase in TC by 11.85%, LDL by 22.51%, VLDL by 21.43% and a decrease in HDL by 20.9% in patients with gout was observed. AR was higher in the group of patients with gout by 25.8% (p=0.0088). An increase in the production of cytokines IL-6 (p=0.0012) and IL-18 (p=0.0008) was observed in patients with gout with UA level above 0.420 mmol/l. There was no significant increase in IL-1β (+0.36, p=0.0154), TNF-α (+0.21, p=0.0944), IL-4 (+0.02, p=0.0028). There was no relationship between IL-6 and CRP (r=0.26, p=0.0122). In the 1st group strong correlations between IL-6 and AR (r=0.762, p=0.0018), IL-18 and AR (r=0.766; p=0.0052) were shown. In the 2nd group correlation between IL-6 and CA was weaker (r=0.292, p=0.0127), with a weak negative correlation between IL-18 and AR (r=-0.366, p=0.0049).
Conclusion. The exceptional role of hyperuricemia in the development of dyslipidemia in patients with gout has not been confirmed. TC, LDL, VLDL and AR are significantly elevated, while HDL is significantly lower in patients during the intercritical period of gout. The increase of IL-6 and IL-18 is accompanied by more prominent indexes of dyslipidemia and clinical manifestations of gouty arthritis.
Keywords:
:gout; hyperuricemia; dyslipidemia; interleukins; cytokine profile.
References
1. Aripov A.N., Nabieva D.A. Determination of proteomic markers of the immunological profile and their relationship with metabolic parameters in patients with gout // Clinical laboratory diagnostics.- 2017.- No. 62(8).- P. 485-489.
2. Nabieva D.A., Mukhamedova N.Kh. Parallelism of multiple lesions in non-alcoholic fatty liver disease in patients with gout and pseudogout // Uzbekiston Tibbiot Journal.-2017.- No. 6.- P. 83-87.
3. Nabiyeva D.A. Quality of life of gouty patients // European journal of researchs.- №5(5).-2017.- R. 24.
4. Nabiyeva D.A. Dyslipidaemia and Cytokine Profile in patients wioth Gout: the role of IL-6, IL-18 and hyperurecemia in the development of metabolic disorders // Journal of Advances in Medicine and Medical research.- 2017.- No. (23.12.) .- 1 -10.
5. Nabieva D.A. Rizamukhamedova M.Z., Ganieva N.A. Study of the effectiveness of plasmapheresis in patients with tofus gout // Therapeutic Bulletin of Uzbekistan.- No. 4.-2015.- P.93-96.
6. Nabieva D.A. Modern approaches to the diagnosis of tofus gout // "Acholining kasallanish kўrsatkichlariga ta'sir qiluvchi hatarli omillar va ularni oldini olishda dolzarb masalalar" ilmiy amaliy conference. - 2014, November 15. - P. 68-72.
7. Rizamukhamedova M.Z., Nabieva D.A., Kurbanova Sh.R. Plasmapheresis in the complex therapy of gout // "Problems of modern rheumatology" conference materials.- April 22-23, 2015.- P. 105-108.
8. Rizamukhamedova M.Z., Nabieva D.A., Kurbanova Sh.R. To metabolic shifts in patients with gout // "Problems of modern rheumatology" materials of the conference.- April 22-23, 2015.- P. 84-87.
9. Rizamukhamedova M.Z., Nabieva D.A., Muhammadieva S.M. Characteristics of metabolic changes in patients with gout // Medical business, Moscow, Russia.- 2016.- No. 1.- P.52-55.
10. Nabieva D.A. Pathology of the hepatobiliary system and gout // Proceedings of the III Eurasian Congress of Rheumatologists. Issues of organization and informatization of healthcare Minsk. - 2016. - P. 240-243.
11. Nabieva D.A. The relationship of hyperuricemia and hyperlipidemia in men with primary gout // Scientific journal young science "Juvenis scienta" St. Petersburg.- 2016.-№ 1.-p. 27-29.
12. Nabieva D.A. Pathology of the hepatobiliary system and gout // Proceedings of the III Eurasian Congress of Rheumatologists, Republic of Belarus. - May 26-27, 2016 Minsk. - P. 240-243.
13. Rizamukhamedova M.Z., Nabieva D.A. Gout bilan ogrigan bemorlarda parkhez taomlarini қўllash // Soғlom parkhez ovkatlanishning dolzarb muammolari. Ilmiy makolalar tuplami, Tashkent.-2017.- P. 138-141.
14. Nabieva D.A., Ne'matova N.A., Rizamukhamedova M.Z., Pulatova Sh.B. Dysmetabolic shifts in patients with gout // 5th Congress of Rheumatologists of Russia.-2009.-P.79.
15. Rizamukhamedova M.Z., Nabieva D.A., Sagatova D.R. Gout arthritis khuruzhida dolak (ketorolakning) samaradorligi // "Achievements and prospects for prevention, diagnosis, treatment and rehabilitation in diseases of internal organs." Scientific and practical conference. Tashkent.- 2009.- P.106.
16. Rizamukhamedova M.Z., Nabieva D.A., Dzhuraeva E.R., Sagatova D.R., Ne'matova N.A. "Mizaj" of gout from the point of view of Ibn Sino // The great heritage of Ibn Sino and Modern Medicine (abstracts of the scientific and practical conference) P. 110.
17. Aripov A.N., Nabieva D.A. Biomarkers and an algorithm for laboratory diagnosis of rheumatic diseases // "Metabolic syndrome: pathogenesis, diagnosis and treatment" abstracts of the Republican Scientific and Practical Conference. - 2011. - P.184.
18. Nabieva D.A. Laboratory diagnosis of acute phase response in arthritis // Metabolic syndrome: pathogenesis, diagnosis and treatment” abstracts of the Republican scientific and practical conference.- 2011.- P.184.
19. Nabieva D.A., Ne'matova N.A., Dzhuraeva E.R., Matchanov S.Kh., Ziyaeva F.K. Risk factors for cardiovascular pathology in gout // VII All-Russian conference of rheumatologists in real clinical practice (collection of conference materials) Vladimir. -2012.- P.35.
20. Nabieva D.A., Miklieva Z.M., Mirkhamidov M.V., Dadakhanov N.E. Glomerular filtration rate in patients with tophi gout and nephrolithiasis.// Therapeutic Bulletin of Uzbekistan.- 2013.- No. 4.-p.197.
21. Lonardo A., Ballestri S., Marchesini G., Angulo P., Loria P. Nonalcoholic fatty liver disease: a precursor of the metabolic syndrome. Digestive and liver disease: official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2015;47(3):181.
22. Afzali, A., Weiss, N.S., Boyko E.J., Ioannou G.N. Association between serum uric acid level and chronic liver disease in the United States. Hepatology 2010;52:578—589.
23. Baldwin W., McRae S., Marek G., et al. Hyperuricemia as a Mediator of the Proinflammatory Endocrine Imbalance in the Adipose Tissue in a Murine Model of the Metabolic Syndrome. Diabetes 2011;60(4):1258—1269.
24. Yang W.H., Liu S.C., Tsai C.H., et al. Leptin induces IL-6 expression through OBRI receptor signaling pathway in human synovial fibroblasts. PLoS ONE. 2013;8(9):e75551.
25. Tsai P.C., Chen C.J., Lai H.M., Chang S.J. Analysis of polymorphisms in the promoter region and protein levels of interleukin-6 gene among gout patients. Clinical and Experimental Rheumatology 2008;26:841—847.
