통풍 환자의 혈청 호모시스테인 변화와 요신 및 지질, 신기능 변화의 연관성: 2년 추적 관찰 연구

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 μmol/L vs. 13.17±3.83 μmol/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. (J Rheum Dis 2016;23:30-36)