Relationship between hyperferritinemia and clinical manifestations of gout

Abstract

Aim. To study the parameters of ferritin, uric acid in the serum and urine, high-sensitivity C-reactive protein (hsCRP) in patients with hypertension in combination with gout and the relationship between these data and clinical manifestations of gout. Materials and methods. 61 patients with hypertension, middle age of whom amounted to 54.25 (10.29) years, had been surveyed, 39 (64 %) men and 22 (36 %) women. All patients were divided into two groups: the main group – 36 patients with hypertension in combination with gout and the comparison group – 25 patients with hypertension without gout. Determination of ferritin level in serum was carried out by using an immunochemical method with electrochemiluminescence detection (Cobas 6000 analyzer, Roche Diagnostics test system,Switzerland). Colorimetric analysis was used to determine the concentration of serum uric acid, the spectrophotometric method – of uric acid in urine, the immunoassay method – of hsCRP. Results. The average serum uric acid level significantly differed (P = 5.4 E-5) in the main group and the comparison group and was 443.44 (129.66) μmol/L and 317.16 (77.60) μmol/L, respectively. The level of ferritin in the main group was significantly higher (237 (237; 247), P = 4.3 E-5 ng/mL) than in the comparison group (137 (83,23; 137) ng/mL), as well as the level of hsCRP (P = 4.4 E-6) 11.78 (3.70; 12.66) mg/L and 1.07 (0; 3.82) mg/L, respectively. The level of uric acid in urine was not significantly different (P = 0.23) in both groups and amounted to 2470.92 (836.89) μmol/L in the main group and 2198.00 (881.73) μmol/L in the comparison group. A significant correlation (r = 0.30; P < 0.05) was found between the levels of serum uric acid and ferritin in the main group patients, as well as a significant correlation between the levels of serum uric acid and the duration of gout (r = 0.41; P < 0.05), the total number of affected joints (r = 0.51; P < 0.05), gout severity (r = 0.36; P < 0.05), the level of ferritin and the number of gout exacerbation (r = 0.31; P < 0.05). Conclusions. Elevated serum ferritin concentration increases the risk of gouty arthritis exacerbation. Establishing the relationship between the concentration of ferritin and serum levels of uric acid and the number of gout exacerbations in the main group suggests that iron plays an important role in the disease pathogenesis.

Keywords

• iron metabolism
• inflammation
• comorbidity
• gout