Glycoprotein acetyl predicts incident, recurrent gout flares
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Key takeaways:
- A total of 88 metabolites were linked to increased risk for incident gout, glycoprotein acetyl being the most prominent.
- The findings have implications for biomarker-based predictions, including for future gout flare risk.
The presence of glycoprotein acetyl predicts first-time and recurring gout flares beyond serum urate, according to data published in Arthritis & Rheumatology.
“As only about 20% of those with prolonged hyperuricemia will go on to develop clinical gout, there is a need to better understand the predictors and mechanistic pathways for development of gout beyond serum urate levels,” Natalie McCormick, PhD, of the division of rheumatology, allergy and immunology at Massachusetts General Hospital, told Healio. “The metabolome holds promise as it sits between the genome and phenome, and is a measure of the status of multiple metabolic pathways.”
To investigate metabolomics for the roles they may play in gout flares, McCormick and colleagues analyzed patients enrolled in the U.K. Biobank. The analysis was hypothesis-free and untargeted to identify novel biomarkers associated with incident and recurrent gout flares. Biobank participants were included in the analysis if they had the proper data available at baseline and had no previous diagnosis of gout or documented use of urate-lowering therapy.
Data in the Biobank cohort included gout assessments as well as disease status based on self-reporting and linked health records indicating a diagnosis of gout, including inpatient hospital care, primary care and death records. The endpoint of incident gout occurrence was measured as the time from the first baseline assessment until the first diagnosis of gout. In patients who had flares occur fewer than 30 days apart, the second flare was considered part of the first flare for analysis purposes.
The analysis included 105,615 participants. Overall, 88 metabolites were linked to increased risk for incident gout. The most prominent among these was glycoprotein acetyl (GlycA), according to the researchers. After adjusting for serum urate levels, GlycA was the only metabolite that remained linked with incident gout exposure (HR = 1.52; 95% CI, 1.22-1.88). Additionally, the association increased when the patient in question had been fasting. In patients who fasted for 8 or more hours before testing, the HR was 4.01 (95% CI, 1.36-11.82). GlycA was also associated with recurring gout flares.
“We identified one metabolic marker, GlycA, that was strongly associated with both the development of gout, and with the rate of recurrent gout flares, even after adjusting for serum urate levels,” McCormick said. “Although it’s too early to consider using GlycA for clinical prediction, this finding has implications for biomarker-based prediction, including for future flare risk among people with gout.”
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