Journal List > J Rheum Dis > v.23(1) > 1064281

Park, Park, Song, and Choi: Two-year Follow-up Study of the Relationship between the Changes of Serum Homocysteine and Those of Serum Uric Acid Levels, Lipid Profiles and Renal Function in Gout Patients

Abstract

Objective

Gout is known to be associated with cardiovascular disease (CVD), and hyperhomocysteinemia is one of the risk factors for CVD. We investigated the associations between the change of serum homocysteine (Hcy) level and those of the other parameters including serum uric acid level, renal function, and cholesterol profiles in chronic gout patients with longitudinal follow-up data.

Methods

Ninety-one male patients with chronic gout and 97 age-matched healthy male control subjects were included in the previous study. Among them, 33 patients with gout and 39 healthy control subjects underwent follow-up tests for Hcy levels with an average of 24.00±9.12 months in this study.

Results

The follow-up data showed that gout patients had significantly higher levels of Hcy in serum than control subjects (16.75±5.43 μ mol/L vs. 13.17±3.83 μ mol/L, p=0.002). In gout patients, the change of serum Hcy level after follow up showed positive correlation with the change of creatinine (γ=0.442, p=0.009) and negative correlation with estimated glomerular filtration rate (eGFR; γ=−0.528, p<0.001). However, the change of serum Hcy level did not show correlation with the changes of uric acid level or the lipid profiles.

Conclusion

Serum Hcy level was elevated in gout patients compared with control subjects. The change of serum Hcy level showed negative correlation with the change of eGFR. Hyperhomocysteinemia in gout patients was associated with decreased renal function, but not with serum uric acid or lipid profiles.

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Figure 1.
The change of serum homocysteine in patients with (A) gout and (B) control.
jrd-23-30f1.tif
Figure 2.
Correlations between the change of serum homocysteine level and the changes of (A) blood urea nitrogen (BUN), (B) serum creatinine (Cr), and (C) estimated glomerular filtration rate (eGFR). The change of serum homocysteine level was positively correlated with the change of Cr, and negatively correlated with the change of serum eGFR.
jrd-23-30f2.tif
Table 1.
Follow-up data of other parameters in gout and control groups
Parameter Gout (n=33) Control (n=39)
Initial Follow-up p-value Initial Follow-up p-value
Age (yr) 54.30±14.59     57.51±13.67    
Uric acid (mg/dL) 6.00±2.39 4.45±1.59 0.007 6.01±1.25 6.07±1.63 NS
BUN (mg/dL) 17.12±5.57 19.39±7.00 0.017 14.67±3.47 14.44±4.46 NS
Cr (mg/dL) 1.19±0.25 1.17±0.29 NS 1.19±0.72 1.60±3.69 NS
eGFR (mL/min) 70.75±16.09 69.61±19.24 NS 79.93±14.68 95.55±17.68 <0.001
Glucose (mg/dL) 100.06±10.13 103.58±18.45 NS 98.38±12.96 96.51±14.61 NS
AST (IU/mL) 26.45±8.01 26.97±9.98 NS 27.03±10.84 26.26±9.02 NS
ALT (IU/mL) 30.95±23.95 27.27±15.80 NS 27.51±11.49 31.07±32.38 NS
TC (mg/dL) 198.20±33.83 182.53±45.48 0.045 204.61±30.55 192.44±45.56 NS
LDL (mg/dL) 120.30±29.57 119.60±38.46 NS 116.43±21.86 107.71±43.32 NS
HDL (mg/dL) 45.23±8.91 46.40±8.72 NS 47.83±9.98 49.31±14.83 NS
TG (mg/dL) 190.06±79.77 134.58±68.51 0.001 149.36±68.13 141.83±116.36 NS

Values are presented as only mean±standard deviation. ALT: alanine aminotransferase, AST: aspartate aminotransferase, BUN: blood urea nitrogen, Cr: creatinine, eGFR: estimated glomerular filtration rate, HDL: high density lipoprotein, LDL: low density lipoprotein, NS: not significant, TC: total cholesterol, TG: triglyceride.

Table 2.
Correlations between the change of serum homocysteine level and the change of other parameters
Change of variable Change of homocysteine
Γ p-value
Uric acid −0.091 NS
BUN 0.336 NS
Cr 0.618 <0.001
eGFR −0.632 <0.001
Glucose 0.029 NS
AST −0.305 NS
ALT −0.299 NS
TC −0.181 NS
LDL 0.171 NS
HDL 0.109 NS
TG −0.277 NS

ALT: alanine aminotransferase, AST: aspartate aminotransferase, BUN: blood urea nitrogen, Cr: creatinine, eGFR: estimated glomerular filtration rate, HDL: high density lipoprotein, LDL: low density lipoprotein, NS: not significant, TC: total cholesterol, TG: triglyceride.

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