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Effects of Urate-Lowering Therapy on Risk of Hyperlipidemia in Gout by a Population-Based Cohort Study and on In

Yi-Jen Fang1,2,3,4,5, Tien-Yuan Wu6,7, Cheng-Li Lin8

  • 1Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Mediators of Inflammation
|December 4, 2020
PubMed

Insights

Gout patients face a higher risk of hyperlipidemia, a condition potentially improved by urate-lowering therapy (ULT). Certain gout medications may reduce hyperlipidemia by impacting liver gene expression related to fat production.

Area of Science:

  • Rheumatology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Gout patients exhibit increased cardiovascular disease risk, often linked to hyperlipidemia.
  • Gout management in Taiwan is suboptimal, and the impact of urate-lowering therapy (ULT) on hyperlipidemia in these patients remains unclear.

Purpose of the Study:

  • To investigate the association between gout and hyperlipidemia risk.
  • To evaluate the effect of ULT on hyperlipidemia in gout patients.
  • To explore the molecular mechanisms of ULT on lipid metabolism.

Main Methods:

  • Retrospective cohort study using Taiwan's Longitudinal Health Insurance Database (LHID).
  • Analysis of new-onset gout patients versus a control cohort using Cox proportional hazards models.
  • Examination of ULT's impact on hepatic lipogenesis-related gene expression in HepaRG cells via real-time polymerase chain reaction.

Main Results:

  • Gout patients demonstrated a significantly higher risk of hyperlipidemia (adjusted hazards ratio [aHR] = 2.55).
  • Gout patients without antigout treatment had a markedly elevated hyperlipidemia risk (aHR = 3.10).
  • Most ULTs, excluding probenecid, were associated with a reduced risk of hyperlipidemia compared to no ULT (all aHR < 0.90).
  • Antigout drugs generally decreased hepatic lipogenesis gene expression in vitro.

Conclusions:

  • Gout is strongly associated with an increased risk of hyperlipidemia.
  • Urate-lowering therapy, particularly certain antigout drugs, may mitigate hyperlipidemia risk in gout patients.
  • These medications appear to reduce hyperlipidemia partly by downregulating hepatic lipogenesis-related genes, improving lipid profiles.

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