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Clustering Patients With Gout Based on Comorbidities and Biomarkers: A Cross-Sectional Study

Fatima K Alduraibi1, Mohammad Saleem2, Karina Ricart3

  • 1F.K. Alduraibi, MD, PhD, Instructor, Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA, Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA, and Division of Clinical Immunology and Rheumatology, Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.

The Journal of Rheumatology
|December 15, 2022
PubMed

Insights

This study identified three distinct patient clusters in gout, revealing that oxidative stress and inflammation markers are key to understanding disease development and clinical presentation for better management.

Area of Science:

  • Rheumatology
  • Clinical Immunology
  • Biochemistry

Background:

  • Gout is a complex inflammatory arthritis with diverse clinical presentations.
  • Understanding patient heterogeneity is crucial for effective management and treatment strategies.

Purpose of the Study:

  • To identify distinct patient clusters based on phenotypes and pathophysiology in gout.
  • To investigate the role of oxidative stress and inflammatory markers in gout subtypes.

Main Methods:

  • Hierarchical cluster analysis of clinical and biological data from gout patients.
  • Assay of serum and plasma samples for inflammatory markers and oxidative stress metabolites.
  • Statistical comparison of identified subgroups using ANOVA and chi-square tests.

Main Results:

  • Three distinct patient clusters were identified: Cluster 1 (early-onset gout, dyslipidemia, hypertension), Cluster 2 (hypertension, dyslipidemia, nephrolithiasis, obesity), and Cluster 3 (multiple comorbidities, tophi).
  • Significant differences in oxidative stress markers (e.g., 3-nitrotyrosine) and inflammatory cytokines (e.g., TNF, IL-1β, IL-6) were observed among the clusters.
  • Reclustering confirmed the stability of these identified patient subgroups.

Conclusions:

  • Oxidative stress and inflammatory marker levels are associated with the development and clinical phenotypes of gout.
  • Measurement of oxidative stress and inflammatory cytokines can serve as adjunctive biomarkers for early gout identification and management.
Abstract

Keywords:
biomarkerscomorbiditygouthyperuricemiauric acid

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