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Clinical characteristics of early- and late-onset gout: A cross-sectional observational study from a Chinese gout clinic.

ABSTRACT: A retrospective cross-sectional study using data from an outpatient clinic in China was conducted to investigate the clinical features of early-onset gout patients.All patients diagnosed with gout were asked about clinical characteristics of their gout and comorbid diseases. Patients presenting with acute flares were asked about common triggers before the flare. "Early-onset" gout was defined as onset of gout before 40 years and "late-onset" as onset ?40 years. Major joint involvement, flare frequency before presentation, the cumulative number of involved joints, proportions of tophi complications at presentation, flare triggers, as well as any metabolic, cardiovascular, cerebrovascular, and renal comorbidities, were compared between the 2 groups.A total of 778 gout patients were enrolled in this study, including 449 (57.7%) in the early-onset group and 329 (42.3%) in the late-onset group. Compared with the late-onset gout patients, the early-onset gout patients had a higher proportion of ankle/mid-foot involvement (62.8% vs 48.2%, P?

SUBMITTER: Zhang B

PROVIDER: S-EPMC5134876 | biostudies-other | 2016 Nov

REPOSITORIES: biostudies-other

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Clinical characteristics of early- and late-onset gout: A cross-sectional observational study from a Chinese gout clinic.

Zhang Bingqing B Fang Weigang W Zeng Xuejun X Zhang Yun Y Ma Ya Y Sheng Feng F Zhang Xinlei X

Medicine 20161101 47

A retrospective cross-sectional study using data from an outpatient clinic in China was conducted to investigate the clinical features of early-onset gout patients.All patients diagnosed with gout were asked about clinical characteristics of their gout and comorbid diseases. Patients presenting with acute flares were asked about common triggers before the flare. "Early-onset" gout was defined as onset of gout before 40 years and "late-onset" as onset ≥40 years. Major joint involvement, flare fre ...[more]

PMID: 27893683

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Project description:BACKGROUND: This study aimed to identify patient-reported outcomes and clinician-assessed characteristics of the first metatarsophalangeal joint (1MTPJ) in people with gout and with asymptomatic hyperuricaemia by comparing them to normouricaemic controls. METHODS: Twenty four people with gout (without current symptoms of acute arthritis), 29 with asymptomatic hyperuricaemia and 34 age- and sex-matched controls participated in this cross-sectional observational study. Patient-reported outcomes included 1MTPJ pain, foot pain and disability, body pain, lower limb function, activity limitation and overall wellbeing. Clinician-assessed characteristics of the 1MTPJ included range of motion (ROM), plantar- and dorsi-flexion force, foot posture, temperature and hallux valgus severity. RESULTS: Compared to controls, participants with gout reported greater 1MTPJ pain (p?=?0.014), greater foot pain and disability (p?<?0.001), increased odds of having disabling foot pain (odds ratio (OR) 13.4, p?<?0.001), decreased lower limb function for daily living (p?=?0.002) and recreational (p?<?0.001) activities, increased activity limitation (p?=?0.002), reduced overall wellbeing (p?=?0.034), reduced ROM (p?<?0.001), reduced plantarflexion force (p?=?0.012), increased 1MTPJ plantar (p?=?0.004), dorsal (p?=?0.003) and medial (p?=?0.004) temperature and had increased odds of having more severe hallux valgus (OR 0.3 p?=?0.041). Compared to controls, participants with asymptomatic hyperuricaemia had increased odds of having disabling foot pain (OR 4.2, p?=?0.013), increased activity limitation (p?=?0.033), decreased lower limb function for daily living (p?=?0.026) and recreational (p?=?0.010) activities, increased 1MTPJ plantarflexion force (p?=?0.004) and a more pronated foot type (p?=?0.036). CONCLUSIONS: People with gout demonstrate 1MTPJ-specific changes indicative of subclinical inflammation, even in the absence of acute arthritis. People with asymptomatic hyperuricaemia, who exhibit no features or symptoms of gout, also report high levels of foot- and lower limb-related pain and disability.

Project description:BackgroundLimited information exists about the nature of late-onset asthma (LOA) without medication intervention when compared to early-onset asthma (EOA). Our goal was to understand how EOA and LOA affect clinical and pathophysiological features.MethodsA population-based cross-sectional study was carried out in Zhongshan Hospital (Shanghai, China). EOA and LOA were based on age of diagnosis (before and after age 40 years, respectively). Clinical variables were collected with an emphasis on allergic features, analyzed, related, and compared using one-way ANOVA or Kruskal-Wallis test. Correlations between blood basophils and clinical data were evaluated by Spearman's rank test. Statistical analyses were conducted with SPSS v24.0.ResultsOf a total of 12,760 adults with cough, sputum, or chest tightness, 90 subjects with EOA (mean age ± standard deviation (SD):28.73 ± 5.89), 111 with LOA (mean age ± SD: 60.25 ± 9.85), and 106 with chronic obstructive pulmonary disease (COPD) (mean age ± SD: 61.58 ± 10.95) were selected. FEV1/FVC (%), FEV1% predicted, and FVC% predicted were all significantly lower in LOA compared to EOA (p < 0.01). The values of post-bronchodilator FEV1 in bronchodilator reversibility testing were higher in the LOA and EOA groups compared to subjects with COPD (p < 0.01). Among allergic features, mite sensitization was most common in EOA patients, followed by LOA and COPD, whereas mold sensitization was more prevalent in LOA than EOA. Moreover, blood eosinophils were a typical feature of asthma in both EOA and LOA compared to COPD and controls (p < 0.01), and there were no differences in blood neutrophils in LOA compared to controls. Interestingly, blood basophils were increased in both EOA (p < 0.01) and LOA (p < 0.05) compared to COPD and controls. This variable correlated with eosinophils in EOA (r = 0.549, p=0.002) but not in LOA.ConclusionLOA is a distinct clinical entity from EOA. In LOA, atopy was less frequent and spirometry values were lower when compared to EOA. In EOA, blood basophils and eosinophils were significantly correlated owing to pathophysiological differences between the two forms of the disease.

Dataset Information

Clinical characteristics of early- and late-onset gout: A cross-sectional observational study from a Chinese gout clinic.

Publications

Clinical characteristics of early- and late-onset gout: A cross-sectional observational study from a Chinese gout clinic.

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