First attacks of gout often precede the diagnosis of metabolic abnormalities and associated diseases
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Serum urate is an independent marker/factor for cardiovascular disease. Hyperuricaemia, a risk factor for gout attack, is associated with insulin resistance, metabolic syndrome, and endothelial dysfunction. A total of 407 consecutive gout patients attending two rheumatology departments in Spain and Mexico were recruited in order to investigate the temporal relationship between the first gout attack and the diagnosis of metabolic syndrome, its components and complications. In 90% of patients, the first attack of gout preceded the diagnosis of metabolic syndrome components, metabolic syndrome itself or its complications. At the time of inclusion (13.7 years after the first gout attack), 93% had at least one associated condition, the most common being hypertriglyceridaemia (63%), obesity (54%), hypertension (45.6%), metabolic syndrome (40%) and hyperglycaemia (37%). Contrarily, prior to the first gout attack, most patients had no diagnosis of any associated disease. These results may provide a unique opportunity to diagnose, prevent and delay long-term complications in this at-risk population.
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