Simple metabolic markers associated with tophaceous gout

Area of Science:

• Rheumatology
• Metabolic Medicine
• Clinical Biochemistry

Background:

• The link between tophaceous gout and metabolic markers requires further elucidation.
• Understanding these relationships is crucial for predicting and managing gout complications.

Purpose of the Study:

• To investigate the correlations between various metabolic markers and the presence of tophi in gout patients.
• To assess the predictive value of these markers for tophus development.

Main Methods:

• Analysis of data from 808 gout patients at Beijing Jishuitan Hospital (2013-2020).
• Inclusion of ten laboratory indicators: uric acid (UA), estimated glomerular filtration rate (eGFR), underexcretion, glucose (GLU), triglycerides (TRIG), HDL-cholesterol (HDL-C), alanine transaminase (ALT), total bilirubin (TBIL), gamma-glutamyl transferase (γ-GT), and urine protein (UPH).
• Evaluation of correlations and predictive performance of metabolic markers and their ratios for tophi.

Main Results:

• Tophi were observed in 14.7% of patients.
• UA, eGFR, ALT, and γ-GT were independently associated with tophi.
• The γ-GT/ALT ratio demonstrated the strongest positive correlation with tophi (rho=0.305, P<0.001) and showed the best classification performance (AUC=0.749, P<0.001).
• Higher γ-GT/ALT ratios correlated with increased incidence of tophi, chronic kidney disease, and long-term hyperuricemia.

Conclusions:

• Uric acid (UA), eGFR, γ-GT, and ALT are independently linked to tophi formation.
• The γ-GT/ALT ratio shows promise as a valuable predictor and monitoring tool for tophaceous gout.