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Original research
Effects of pharmacological reversal of hyperuricemia on features of the metabolic syndrome in patients with gouty arthritis
  1. Mariana Marin1,
  2. Naim M Maalouf2
  1. 1Department of Internal Medicine, Divisions of Mineral Metabolism and Endocrinology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
  2. 2Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, and Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Naim M Maalouf, Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, and Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Naim.Maalouf{at}UTSouthwestern.edu

Abstract

Hyperuricemia has been associated in epidemiological studies with the development of obesity, hypertension, insulin resistance and type 2 diabetes. Nevertheless, it remains unclear whether lowering of serum uric acid (UA) alters any of the features of the metabolic syndrome. In this prospective study (ClinicalTrials.gov identifier: NCT01654276), 24 patients with gouty arthritis and hyperuricemia were treated for 6 months with the xanthine oxidase inhibitor febuxostat to lower serum UA to <6 mg/dL. Measurements of 24 hours ambulatory blood pressure (ABP) and serum and urine markers of the metabolic syndrome were measured at baseline and at the end of 6 months of febuxostat. The study population consisted of 18 men and 6 women, 18 of which completed the baseline and 6 months visits. Serum UA decreased significantly from 8.7±1.5 mg/dL at baseline to 4.4±1.1 mg/dL at 6 months (P<0.0001). During that time frame, there was no significant change in body mass index, systolic or diastolic blood pressure measured by 24 hours ABP monitor, serum glucose, insulin or homeostatic model assessment for insulin resistance, serum total and high-density lipoprotein-cholesterol, serum triglycerides or urine pH (P>0.05 for all). There was no correlation between parameters of the metabolic syndrome and the decline in serum UA or serum UA achieved at study end. In conclusion, in patients with gouty arthritis, UA lowering with febuxostat below 6 mg/dL had no significant impact on features of the metabolic syndrome.

  • uric acid
  • gout
  • metabolic syndrome
  • febuxostat
  • hypertension
  • hyperuricemia

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Footnotes

  • Contributors MM contributed to subject recruitment, follow-up, data collection and drafting of manuscript. NMM contributed to subject recruitment, study conduct and supervision, data analysis and manuscript review.

  • Funding This study was funded in part by an investigator-initiated grant (MSA-NC-FEB-137) to Dr Maalouf from Takeda Pharmaceuticals (USA). This grant provided research costs to UT Southwestern.

  • Disclaimer Takeda Pharmaceuticals had no role (either direct or indirect) in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors had no other relationship or involvement with Takeda Pharmaceuticals.

  • Competing interests This study was funded in part by an investigator-initiated grant (MSA-NC-FEB-137) to Dr Maalouf from Takeda Pharmaceuticals (USA). This grant provided research costs to UT Southwestern.

  • Patient consent Obtained.

  • Ethics approval The study was reviewed and approved by the Institutional Review Board at the University of Texas Southwestern Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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