ASSOCIATION OF CLINICAL MANIFESTATIONS AND COMORBIDITIES WITH QUALITY-OF-LIFE MEASURES IN PATIENTS WITH GOUT

Abstract

Objective: to identify factors associated with low quality of life (QL) in patients with gout. Subjects and methods. The investigation enrolled 175 patients (153 men and 22 women) with a definite diagnosis of gout. Their mean age was 48.0±12.3 years; median disease duration – 5.7 [3.0; 12.3] years; the annual number of arthritis attacks – 3 [1; 5]; and the mean serum level of uric acid (UA) – 510±120 μmol/l. 31.4% of the patients received allopurinol; 40.5% had chronic arthritis; 36.5% – subcutaneous tophi, 23% – coronary heart disease (CHD); 76% – hypertension; 15.4% – type 2 diabetes mellitus (DM); 10.2% – chronic kidney disease (CKD) at a glomerular filtration rate of <60 ml/min; 56% – obesity; 5.1% – chronic heart failure (СHF); 9.1% – history of vascular catastrophes. Pearson’s and Spearman’s correlation analyses were made to reveal correlations between QL measures according to the EQ-5D and SF-36v1 questionnaires, HAQ functional status (FS), and the clinical characteristics of the disease, as well as comorbidities. Multiple regression analysis was used to identify factors worsening QL. Results and discussion. Negative correlations were found between SF-36 QL measures and age, disease duration, serum UA level, presence of chronic arthritis and tophi, use of allopurinol, diuretics, alcohol, as well as hypertension, CHD, obesity, vascular catastrophes, CKD, and CHF. The multiple regression analysis established a direct association between HAQ FS worsening and female gender, elderly age, number of inflamed joints and frequency of arthritis attacks; the coefficient of multiple determination (R2) was 0.41. EQ QL correlated inversely with age, number of inflamed joints, frequency of arthritis attacks, intake of diuretics and obesity (R2 = 0.33). The reduction in the SF-36 physical health component correlated with increases in age, number of inflamed joints, and frequency of arthritis attacks, presence of CKD (R2 = 0.3); a weak association was noted between worsening mental health component and female gender, increased number of inflamed joints, and vascular catastrophes (R2 = 0.1). Conclusion. Decreased QL in gout is independently associated with higher number of inflamed joints, frequency of arthritis attacks, elderly age, female gender, and comorbidities (CKD, obesity, vascular catastrophes).

Keywords

• gout
• quality of life
• comorbidies