Obesity, Echocardiographic Changes and Framingham Risk Score in the Spectrum of Gout: A Cross-Sectional Study

Area of Science:

• Cardiology
• Rheumatology
• Obesity Medicine

Background:

• Gout is associated with increased cardiovascular risk.
• Obesity is a common comorbidity in gout patients.
• The impact of obesity on cardiovascular structure and function in gout requires further elucidation.

Purpose of the Study:

• To assess cardiovascular risk using Framingham Risk Score (FRS) and echocardiographic parameters in obese versus non-obese patients across the gout spectrum.
• To investigate morphological and functional cardiac changes associated with obesity in patients with asymptomatic hyperuricemia, gouty arthritis without tophi, and gouty tophi.

Main Methods:

• A single-center cross-sectional study included 201 patients categorized by gout status and obesity.
• Evaluated Body Mass Index (BMI), FRS, and echocardiographic measures including Left Atrium (LA) size and Left Ventricular Posterior Wall (PW) thickness.
• Statistical analyses included t-tests, Mann-Whitney U tests, ANOVA, and multiple linear regression models.

Main Results:

• No significant differences in FRS or functional echocardiographic parameters (FS, S', E', E/E') were observed between obese and non-obese groups across all gout stages.
• Obese patients consistently exhibited larger LA dimensions and thicker LV PW compared to their non-obese counterparts.
• Increased BMI was an independent predictor of increased LV PW thickness in all gout patient groups.

Conclusions:

• Obesity is associated with adverse cardiac morphological changes (larger LA, thicker PW) in patients with gout, irrespective of disease stage.
• While functional parameters and FRS did not differ, structural alterations highlight a potential cardiovascular burden in obese gout patients.
• The combination of high urate load, chronic inflammation, and obesity may exacerbate cardiac alterations, particularly in gout with tophi.