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Vol. 20. Issue 6.
Pages 291-296 (June - July 2024)
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Vol. 20. Issue 6.
Pages 291-296 (June - July 2024)
Original article
Clinical implications of persistent joint pain after gout flare
Significado clínico del dolor articular persistente después del ataque de gota
Wei Liua, Peng Dongb, Chunyan Lic, Wen Guod, Kaiping Zhaoe, Siliang Mana, Liang Zhangf, Husheng Wua, Hui Songa,
Corresponding author
jst_fsmyk@126.com

Corresponding author.
a Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
b Changzhou Xitaihu Institute for Frontier Technology of Cell Therapy, Changzhou, China
c Department of Clinical Laboratory, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
d Department of Ultrasound, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
e Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
f Department of Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
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Tables (3)
Table 1. Demographic and basic clinical information of patients with persistent and non-persistent joint pain after gout flare.
Table 2. Comparison of joint involvement in patients with persistent and non-persistent joint pain after gout flare.
Table 3. Laboratory measures and comorbidities in patients with persistent and non-persistent joint pain after gout attack.
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Abstract
Objectives

A subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis.

Methods

We analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares.

Results

A total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (P<0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% vs. 21.1%) and bone erosion (18.6% vs. 8.6%) (P<0.05). Higher UA and lower TBil were found in patients with persistent joint pain (P<0.001). Hypertension (54.9% vs. 38.7%) and metabolic syndrome (58.8% vs. 46.4%) were both more frequent in patients with persistent joint pain (P<0.05). TBil was negatively correlated with the incidence of persistent joint pain (P<0.001, r=−0.190), UA values (P<0.001, r=−0.125), and metabolic syndrome scores (P<0.001, r=−0.192). A correlation curve was fitted using LOESS (locally weighted region).

Conclusion

Persistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.

Keywords:
Gout
Bilirubin
Arthritis
Metabolic syndrome
Resumen
Objetivos

Un subgrupo de pacientes con gota desarrolló dolor articular persistente tras los brotes. El análisis de este fenómeno clínico puede arrojar más luz sobre los factores relacionados con el empeoramiento de la gota e incluso proporcionar pistas sobre su patogenia.

Métodos

Analizamos los datos clínicos, de laboratorio y de ultrasonido de los pacientes para explorar la asociación de estos datos con el dolor articular persistente después de un ataque de gota.

Resultados

Se incluyeron 1029 pacientes en el estudio: 182 (17,7%) con dolor articular persistente y 847 (82,3%) con dolor articular insostenible. Los pacientes con dolor articular persistente tenían un mayor número total de articulaciones afectadas, más ataques gotosos en el último año y más articulaciones con ataques gotosos simultáneos (p<0,01), y los pacientes con dolor articular persistente tenían una mayor incidencia de cálculos gotosos (36,4% frente a 21,1%) y erosión ósea (18,6% frente a 8,6%) (p<0,05). Los pacientes con dolor articular persistente tenían un ácido úrico más alto y una bilirrubina más baja (p<0,001). La hipertensión arterial (54,9% frente al 38,7%) y el síndrome metabólico (58,8% frente al 46,4%) son más frecuentes en pacientes con dolor articular persistente (p<0,05). La bilirrubina se asocia negativamente con la incidencia de dolor articular persistente, ácido úrico y síndrome metabólico. Una curva de correlación fue ajustada con Loess (región de peso local).

Conclusión

El dolor articular persistente después del ataque de gota es una marca de aumento de la carga de la enfermedad en la gota. La importancia de los niveles de bilirrubina total en el empeoramiento de la gota merece un estudio más detallado.

Palabras clave:
Gota
Bilirrubina
Artritis
Síndrome metabólico

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