Dataset Information

Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis.

ABSTRACT: Uric acid urolithiasis constitutes approximately 7-10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, p < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01-0.61, p = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01-0.61, p = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.

SUBMITTER: Liu CJ

PROVIDER: S-EPMC6832126 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis.

Liu Chan Jung CJ Wu Jin Shang JS Huang Ho Shang HS

Journal of clinical medicine 20190925 10

Uric acid urolithiasis constitutes approximately 7-10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or ...[more]

PMID: 31557790

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Project description:Diabetes mellitus is a metabolic disease closely related to a disordered gut microbiome. Diabetic patients usually suffer from various metabolic disorders, such as increased serum uric acid levels. Although serum uric acid levels depend partially on intestine excretion, the relationship between uric acid and gut microbiome in diabetic patients remains unknown. We collected a total of 126 fecal samples from diabetic patients for 16S ribosomal RNA gene amplicon sequencing and recorded clinical data. We analyzed the correlation between clinical indicators and gut microbiota of diabetic patients using Spearman analysis. Since uric acid was the most prominent one, we classified diabetic patients based on their uric acid levels to find the microbiome associated with uric acid disturbance. We constructed Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway profiles using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) to identify variations between the different groups. Among all the clinical indicators, uric acid had the strongest correlation with gut microbiota. First, we divided the patients into three groups according to their uric acid levels. The two low uric acid groups were similar, while the elevated uric acid group had significant differences in gut microbiota and metabolic pathways. The elevated uric acid group had a significantly lower gut microbiota diversity. At the genus level, this group had remarkably higher Escherichia–Shigella amounts and notably lower Faecalibacterium, Oscillospiraceae_UCG−002, and Oscillospiraceae_UCG−005 amounts. The gut microbiota of the high uric acid group was predicted to be enriched in metabolism, human diseases, and lipopolysaccharide biosynthesis. Since the two low uric acid groups were similar, we regrouped and matched the abnormal uric acid patients with normal uric acid patients. The differences in gut microbiota and metabolic pathways related to nucleotide metabolism became more significant. The serum uric acid levels were associated with gut microbiome changes. This might be related to uric acid metabolism by gut microbes. Our study indicates that targeting the gut microbiome could help manage elevated uric acid levels.

Project description:ObjectiveThe effects of coffee consumption on serum uric acid (SUA) levels and gout risk are controversial. There have hitherto been no reports based on Mendelian randomization (MR) analysis of its effects that consider pleiotropy. Here, we evaluated the effects of coffee consumption across ancestry populations, taking pleiotropy into account.MethodsWe performed the first MR analyses for coffee consumption on SUA levels and gout, considering pleiotropy. We used the following summary statistics of genome-wide association studies from a Japanese population: habitual coffee consumption (152,634 subjects), gout (3053 cases and 4554 controls), and SUA levels (121,745 subjects). In addition to fixed-effect inverse variance weighted (IVW) meta-analysis, we performed a robust evaluation of heterogeneity and removed several instruments for reasons of possible pleiotropy. Previous European datasets were also reevaluated while heterogeneity was considered.ResultsHabitual coffee consumption was significantly and inversely associated with gout (odds ratio [OR] = 0.29, 95% confidence interval [95% CI]: 0.16-0.51, P = 1.9 × 10-5 ) in random-effect IVW (Phet = 5.5 × 10-19 ). Excluding pleiotropic instruments, the protective effect on gout was confirmed in fixed-effect IVW analysis (OR = 0.75, 95% CI: 0.58-0.97, P = 0.026) without heterogeneity (Phet = 0.39). However, we observed no significance in the previous European datasets when heterogeneity was considered. Associations were not observed between coffee consumption and SUA levels in either ancestry in MR analyses that considered pleiotropy. Multivariable MR analysis showed that increased coffee consumption significantly reduced gout risk, even after adjusting for SUA levels (OR = 0.50, 95% CI: 0.31-0.81, P = 0.0046).ConclusionWith pleiotropy taken into account, our MR analyses revealed that coffee consumption can causally reduce gout risk, and that it may reduce gout risk independently of SUA levels.

Project description:Background Early onset gout has received increasing interest from researchers. Previous studies have reported that serum urate (sUA) levels and prevalence of obesity are higher in early onset gout patients than in later-onset gout patients. We explored the dietary habits of early onset and later-onset gout patients and their association with clinical features. Materials and Methods Gout patients completed a 10-item food frequency questionnaire. Early onset gout patients were defined as gout onset before the age of 40, and onset after age 40 was classified as later-onset. Associations between dietary factors, obesity, and sUA level of ≥600 μmol/L were assessed using logistic regression. Results Among the 655 gout patients, 94.6% were males, and 59.1% presented with early onset gout. All early onset patients were males. sUA level was significantly higher in the early onset group than in the later-onset group (550.7 vs. 513.4 μmol/L). The proportion of patients with a sUA level of ≥ 600 μmol/L (40.3 vs. 26.2%) and obesity (27.6 vs. 10.7%) was higher in the early onset group than in the later-onset group (all p < 0.05). The early onset group consumed more red meat (101–200 g/day: 43.6 vs. 26.0%), sugar-sweetened beverages (>4 times/week: 27.9 vs. 7.7%), and milk and milk products (1–2 times/week: 28.5 vs. 16.6%), but less alcohol (>84 g/day: 8.5 vs. 21.5%) and tea (>4 times/week: 35.7 vs. 52.4%; all p < 0.05). Sugar-sweetened beverage intake was positively correlated with sUA level of ≥600 μmol/L (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.4, 3.7) and obesity (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.2, 3.7). These correlations remained significant for early onset gout patients. Conclusion Sugar-sweetened beverage intake replaced alcohol as the main dietary risk factor for gout in early onset patients, and this change was associated with a greater prevalence of obesity and higher sUA level. Clinicians should provide specific dietary education for different generations of gout patients. The epidemic of sugar-sweetened beverage consumption should be considered for the development of public health policies for the prevention of gout.

Dataset Information

Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis.

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Decreased Associated Risk of Gout in Diabetes Patients with Uric Acid Urolithiasis.

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