Gout: What management focuses can improve prognosis?

Rekalov D.¹, Bortkevich O.¹, Danyuk I.², Chorna S.²

• ¹State Institution «National scientific center «Institute of Cardiology named after academician M.D. Strazhesko» National Academy of Medical Sciences of Ukraine, Kyiv
• ²Zaporizhzhia State Medical and Pharmaceutical University

Summary. Gout is one of the most common inflammatory arthropathies in men, but it also occurs in women, especially in the postmenopausal period. Uric acid is considered the end product of purine metabolism in humans. Evidence suggests that elevated serum uric acid levels are associated with the development of arterial hypertension, coronary heart disease, stroke, acute myocardial infarction, and cardiovascular disease. Hyperuricemia is a laboratory phenomenon, it is a persistent increase in serum uric acid concentration. Up to 21% of the general population and 25% of hospitalized patients are estimated to have asymptomatic hyperuricemia, and uric acid levels can be elevated 10 to 15 years before clinical manifestations of gout. The solubility of uric acid is determined by the saturation point of the MUN in plasma and is 6.8 mg / dl (408 μmol / l) for men and 7.0 mg / dl (420 μmol / l) for women. In vitro, sodium monourate crystals form at uric acid levels > 6.0 mg/dL (> 360 μmol/L) at 35°C. Crystalline urates are biologically active molecules that can cause adverse vascular, metabolic and inflammatory phenomena. According to many population studies, the relationship between hyperuricemia and renal, cardiovascular and metabolic diseases is also clear and convincing. Given the high incidence of asymptomatic hyperuricemia, the increasing prevalence of vascular, metabolic and renal diseases and the effectiveness and availability of urate-lowering therapy, which can reduce the impact of the ongoing metabolic epidemic, the role of uric acid crystals remains a relevant and important debate and research challenge. The effectiveness of xanthine oxidase inhibitors extends not only to the relief of acute gout symptoms, but also to the chronic nature of hyperuricemia.