Endocrinological aspects of gout

Abstract

Gout is the most common inflammatory joint disease, and its incidence increases with age and the presence of certain diseases, primarily obesity and chronic kidney disease, as well as while taking certain medications. Treatment of a patient with gout requires the interaction of a rheumatologist, cardiologist and endocrinologist, and even better, a well-trained therapist who is able to independently supervise gout-related diseases without the involvement of specialized specialists. This review was written to highlight current data on the most common endocrinopathies in gout for practitioners. The data presented indicate the existence of a relationship between gout and various endocrine diseases. The most important aspect is the presence of metabolic syndrome in most patients with gout, the treatment of which also requires taking into account the effect of prescribed drugs on purine metabolism. On the other hand, effects on certain endocrinological diseases can lead to improved purine metabolism. It has been shown that weight loss, including through bariatric means, is accompanied by a decrease in uric acid levels and may be accompanied by a decrease in the need for urate-lowering therapy. Most glucose-lowering drugs affect purine metabolism, and the presence of concomitant gout may determine the specific choice of antidiabetic therapy. Menopause is characterized by an increase in uric acid levels and the incidence of gout. At the same time, the use of menopausal hormone therapy may be accompanied by both a decrease in uric acid levels and the risk of developing gout. Despite the fact that an increase in testosterone levels in men is positively correlated with uric acid levels, its deficiency is accompanied not by a decrease, but by an increase in uric acid levels.