Credit: Original article published here.
According to a study published in the World Journal of Hepatology, gout complications were more common in patients with cirrhosis.
“A positive correlation between serum [uric acid] levels, cirrhosis-related complications, and the incidence of nonalcoholic fatty liver disease has been established,” the researchers noted, “but it is unknown whether hyperuricemia results in worsening cirrhosis outcomes.” They set out to examine the association between cirrhosis and the incidence of gout-related complications.
Their cross-sectional study used the National Inpatient Sample to identify patients hospitalized with gout from 2001 to 2013. The patients were stratified based on a history of cirrhosis. Primary outcomes were mortality, gout complications, and joint interventions. The χ2 test and independent t test were performed to assess categorical and continuous data, respectively. Multiple logistic regression was used to control for confounding variables.
The results of the study showed that patients with cirrhosis had greater rates of mortality (5.49% vs 2.03%), gout flare (2.89% vs 2.77%), and tophi (0.97% vs 0.75%) compared with patients without cirrhosis. However, patients without cirrhosis had higher rates of arthrocentesis (2.45% vs 2.21%) and joint injections (0.72% vs 0.52%).
The study also found that patients without cirrhosis were older (70.37 years vs 66.21 years). Most patients were male (74.63% with cirrhosis vs 66.83% without).
These results indicate that gout complications were more common in patients with cirrhosis compared with those without cirrhosis. The study suggests that health care providers may have hesitated to perform joint interventions due to the higher complication risk associated with cirrhosis, leading to lower rates of interventions in patients without cirrhosis.
The study has some limitations, including the cross-sectional design, which does not allow for causal inference. The use of administrative codes to identify patients with gout may have resulted in some misclassification. Additionally, the study did not account for potential confounders such as dietary factors, medication use, and comorbidities.
“Patients with cirrhosis may have differential rates of gout exacerbations and potential therapeutic options due to a combination of pathophysiology, cirrhosis-related comorbidities, and clinical decision-making. As there are few studies connecting both disease states, more investigation is required to further delineate the relationship between liver disease and gout,” the researchers concluded.
Source: World Journal of Hepatology
