The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.5.227789

Keywords:

hypertension, gout, markers of inflammation, intima-media complex, vascular wall

Abstract

The aim. To analyze the frequency of atherosclerotic lesions of the carotid arteries and association with the lipid metabolism and inflammatory markers in hypertensive patients with gout.

Materials and methods. 122 patients with hypertension aged 30 to 65 years were examined (mean age (56.0 (47.0; 62.0)), inclu­ding 104 men (85.2 %) and 18 women (14.8 %). Group 1 included 72 hypertensive patients with gout; group 2 – 50 hypertensive patients without gout; group 3 – 20 gout patients without hypertension. Serum levels of high sensitivity C-reactive protein were detected by enzyme-linked immunosorbent assay. Serum ferritin levels were measured using electrochemiluminescent detection. The patients underwent carotid artery ultrasound according to standard methods.

Results. The duration of gout exacerbation and the pain intensity evaluated with the visual analog scale (VAS) (P < 0.01) were significantly higher in group 1, than those in group 3 (P < 0.01). Serum ferritin levels were 2.6 (P < 0.01) times higher in group 1 than those in group 2. In patients with gout, the levels of ferritin were significantly 2.1 times higher, than in group 2 (P < 0.01). The levels of hsСRP in patients of group 1 were 3.1 times higher than those in group 2 (P < 0.01). The proportion of patients with intima-media complex (IMC) thickness ≥0.9 mm was higher in group 1 than in groups 2 (χ2 = 4.58, P < 0.05) and 3 (χ2 = 24.96, P < 0.01). In the structure of plaques, isoechoic were significantly more often seen among group 1 patients as compared to group 3 (χ2 = 6.56, P < 0.01), and hyperechoic – as compared to group 2 (χ2 = 4.63, P < 0.05). Hypoechoic plaques were detected in groups 1 and 2 with similar frequency (P > 0.05). This type of plaque was associated with a high risk of cerebrovascular events. In the patients with arterial hypertension and gout, a significant moderate positive correlation was found between the IMC thickness and the serum uric acid level (rs = 0.46, P < 0.01), hsCRP (rs = 0.33, P < 0.01), age (rs = 0.33; P < 0.01), duration of gout (rs = 0.27, P < 0.05) and VAS (rs = 0.39, P < 0.01); the level of hsCRP was correlated with the presence of atherosclerotic plaques (τ = +0.64, P < 0.05).

Conclusions. The combination of hypertension with gout in patients was associated with a high incidence of IMC thickness ≥0.9 mm and atherosclerotic plaques, more severe disorders of purine and lipid metabolism, increased inflammatory markers (ferritin and hsCRP), that should be considered not only in the aspect of chronic inflammation, but also as a part of the disease.

Author Biographies

H. P. Kuzmina, Dnipro State Medical University, Kryvyi Rih, Ukraine

MD, PhD, DSc, Professor of the Department of Therapy, Cardiology and Family Medicine

O. M. Lazarenko, Dnipro State Medical University, Kryvyi Rih, Ukraine

MD, PhD, Assistant of the Department of Therapy, Cardiology and Family Medicine

References

Joo, H. J., Kim, G. R., Choi, D. W., Joo, J. H., & Park, E. C. (2020). Uric acid level and kidney function: a cross-sectional study of the Korean national health and nutrition examination survey (2016-2017). Scientific Reports, 10(1), Article 21672. https://doi.org/10.1038/s41598-020-77702-x

Wu, A. H., Gladden, J. D., Ahmed, M., Ahmed, A., & Filippatos, G. (2016). Relation of serum uric acid to cardiovascular disease. International Journal of Cardiology, 213, 4-7. https://doi.org/10.1016/j.ijcard.2015.08.110

Badimon, L., Peña, E., Arderiu, G., Padró, T., Slevin, M., Vilahur, G., & Chiva-Blanch, G. (2018). C-Reactive Protein in Atherothrombosis and Angiogenesis. Frontiers in Immunology, 9, Article 430. https://doi.org/10.3389/fimmu.2018.00430

Franceschini, N., Giambartolomei, C., de Vries, P. S., Finan, C., Bis, J. C., Huntley, R. P., Lovering, R. C., Tajuddin, S. M., Winkler, T. W., Graff, M., Kavousi, M., Dale, C., Smith, A. V., Hofer, E., van Leeuwen, E. M., Nolte, I. M., Lu, L., Scholz, M., Sargurupremraj, M., Pitkänen, N., … O'Donnell, C. J. (2018). GWAS and colocalization analyses implicate carotid intima-media thickness and carotid plaque loci in cardiovascular outcomes. Nature Communications, 9(1), Article 5141. https://doi.org/10.1038/s41467-018-07340-5

Plasencia Martínez, J. M., & García Santos, J. M. (2017). Is manual ultrasonographic measurement of carotid intima-media thickness a reproducible cardiovascular biomarker? Es la medida ecográfica manual del grosor íntima-media carotídeo un biomarcador cardiovascular reproducible? Radiologia, 59(6), 478-486. https://doi.org/10.1016/j.rx.2017.07.001

Xiong, X. D., Xiong, W. D., Xiong, S. S., & Chen, G. H. (2017). Research Progress on the Risk Factors and Outcomes of Human Carotid Atherosclerotic Plaques. Chinese Medical Journal, 130(6), 722-729. https://doi.org/10.4103/0366-6999.201598

Poredos, P., Gregoric, I. D., & Jezovnik, M. K. (2020). Inflammation of carotid plaques and risk of cerebrovascular events. Annals of Translational Medicine, 8(19), Article 1281. https://doi.org/10.21037/atm-2020-cass-15

Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G., … ESC Scientific Document Group. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 39(33), 3021-3104. https://doi.org/10.1093/eurheartj/ehy339

Janssens, H., Fransen, J., Janssen, M., Neogi, T., Schumacher, H. R., Jansen, T. L., Dalbeth, N., & Taylor, W. J. (2017). Performance of the 2015 ACR-EULAR classification criteria for gout in a primary care population presenting with monoarthritis. Rheumatology, 56(8), 1335-1341. https://doi.org/10.1093/rheumatology/kex164

Neogi, T., Jansen, T. L., Dalbeth, N., Fransen, J., Schumacher, H. R., Berendsen, D., Brown, M., Choi, H., Edwards, N. L., Janssens, H. J., Lioté, F., Naden, R. P., Nuki, G., Ogdie, A., Perez-Ruiz, F., Saag, K., Singh, J. A., Sundy, J. S., Tausche, A. K., Vaquez-Mellado, J., … Taylor, W. J. (2015). 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Annals of the Rheumatic Diseases, 74(10), 1789-1798. https://doi.org/10.1136/annrheumdis-2015-208237

Ramirez, A. J., Christen, A. I., & Sanchez, R. A. (2018). Serum Uric Acid Elevation is Associated to Arterial Stiffness in Hypertensive Patients with Metabolic Disturbances. Current Hypertension Reviews, 14(2), 154-160. https://doi.org/10.2174/1573402114666180413143312

Canepa, M., Viazzi, F., Strait, J. B., Ameri, P., Pontremoli, R., Brunelli, C., Studenski, S., Ferrucci, L., Lakatta, E. G., & AlGhatrif, M. (2017). Longitudinal Association Between Serum Uric Acid and Arterial Stiffness: Results From the Baltimore Longitudinal Study of Aging. Hypertension, 69(2), 228-235. https://doi.org/10.1161/HYPERTENSIONAHA.116.08114

Song, M., Li, N., Yao, Y., Wang, K., Yang, J., Cui, Q., Geng, B., Chen, J., Wang, Y., Cheng, W., & Zhou, Y. (2019). Longitudinal association between serum uric acid levels and multiterritorial atherosclerosis. Journal of Cellular and Molecular Medicine, 23(8), 4970-4979. https://doi.org/10.1111/jcmm.14337

An, L. N., Rong, N., Ning, M., Feng, L. L., Chen, Z. H., Liu, W. Q., Ouyang, X. C., Diao, F. R., Han, Z. G., & Hong, J. (2020). High serum uric acid is associated with increased arterial stiffness in hypertension. Aging, 12(14), 14569-14581. https://doi.org/10.18632/aging.103506

Drivelegka, P., Forsblad-d'Elia, H., Angerås, O., Bergström, G., Schmidt, C., Jacobsson, L., & Dehlin, M. (2020). Association between serum level of urate and subclinical atherosclerosis: results from the SCAPIS Pilot. Arthritis Research & Therapy, 22(1), Article 37. https://doi.org/10.1186/s13075-020-2119-0

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Published

2021-09-01

How to Cite

1.
Kuzmina HP, Lazarenko OM. The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers. Zaporozhye Medical Journal [Internet]. 2021Sep.1 [cited 2024Nov.22];23(5):608-13. Available from: http://zmj.zsmu.edu.ua/article/view/227789

Issue

Vol. 23 No. 5 (2021)

Section

Original research

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