痛風患者における高リポ蛋白血症(第1報)

-高リポ蛋白血症 phenotype の検討-

抄録

We investigated serum lipoprotein levels and hyperlipoproteinemic phenotypes in 195 patients with primary gout, in order to clarify the frequency and magnitude of hyperlipoproteinemia. The patients were divided into two groups, one that had not received treatment prior to the first visit to our gout clinic, and the other that had compared with health control subject without hyperuricemia. The serum levels of cholesterol (CH) and triglyceride (TG) were increased, and high density lipoprotein cholesterol (HDL-C) levels were decreased in both groups, The frequency of hyperlipoproteinemia was 50% in the gouty group, and 56% untreated group. Phenotypes of hyperlipoproteinemia was determined by using with poJyacrylamide gel disc electrophoresis. The frequency of type IV was higher. in the gouty group than that in 877 primary hyperlipoproteinemic patients, that of type II a was, however lower. We compared the changes of serum lipid levels and phenotypes between before and after treatment by anti - hyperuricemic agents. The phenotypes of 21 cases (15%) changed from hyperlipidemia to normolipidemia, that of 13 ca. ses (14%), from normolipidemia to hyperlipidemia. The phenotypes of 10 cases (12%)varied between type II and IV, suggesting a possible linkage of combined hyperlipidemia with gout.
Furtheremore, we assessed the influence of alcohol intake and obesity on occurrence of hyperlipoproteinemia in gout. In order to neglect the effect of two factors, we investigated the levels serum lipids and hyperlipoproteinemic phenotypes of ten non-drinkers who had body weight within 80-120% of the ideal body weight. Those of CH and TG were still higher in them than in controls, and those of HDL-C were lower. In conclusion, alcohol intake and obesity might be promoting factors of hyperlipoproteinemia in gout, but not initiating factors.