scholarly journals Association of Specific Comorbidities with Monosodium Urate Crystal Deposition in Urate-Lowering Therapy-Naive Gout Patients: A Cross-Sectional Dual-Energy Computed Tomography Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1295
Author(s):  
Tristan Pascart ◽  
André Ramon ◽  
Sébastien Ottaviani ◽  
Julie Legrand ◽  
Vincent Ducoulombier ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Computed Tomography ◽  
Chronic Heart Failure ◽  
Dual Energy ◽  
Bivariate Analysis ◽  
Monosodium Urate ◽  
Cross Sectional ◽  
Crystal Deposition ◽  
Lowering Therapy

(1) Background: To determine which factors are associated with the volume of monosodium urate (MSU) crystal deposition quantified by dual-energy computed tomography (DECT) in urate-lowering therapy (ULT)-naive gout patients. (2) Methods: In this multicenter cross-sectional study, DECT scans of knees and feet/ankles were prospectively obtained from ULT-naive gout patients. Demographic, clinical (including gout history and comorbidities), and biological data were collected, and their association with DECT MSU crystal volume was analyzed using bivariate and multivariate analyses. A second bivariate analysis was performed by splitting the dataset depending on an arbitrary threshold of DECT MSU volume (1 cm3). (3) Results: A total of 91 patients were included. In the bivariate analysis, age (p = 0.03), gout duration (p = 0.003), subcutaneous tophi (p = 0.004), hypertension (p = 0.02), diabetes mellitus (p = 0.05), and chronic heart failure (p = 0.03) were associated with the total DECT volume of MSU crystal deposition. In the multivariate analysis, factors associated with DECT MSU volumes ≥1 cm3 were gout duration (odds ratio (OR) for each 10-year increase 3.15 (1.60; 7.63)), diabetes mellitus (OR 4.75 (1.58; 15.63)), and chronic heart failure (OR 7.82 (2.29; 31.38)). (4) Conclusion: Specific comorbidities, particularly chronic heart failure and diabetes mellitus, are more strongly associated with increased MSU crystal deposition in knees and feet/ankles than gout duration, regardless of serum urate level.

scholarly journals THU0437 SPECIFIC COMORBIDITIES ENHANCE MONOSODIUM URATE CRYSTAL DEPOSITION IN GOUT: A MULTICENTRE DUAL-ENERGY COMPUTED TOMOGRAPHY STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 455.1-456
Author(s):  
T. Pascart ◽  
A. Ramon ◽  
S. Ottaviani ◽  
J. Legrand ◽  
V. Ducoulombier ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Dual Energy ◽  
Biological Data ◽  
Bivariate Analysis ◽  
Dual Energy Ct ◽  
Crystal Formation ◽  
Monosodium Urate ◽  
Crystal Deposition

Background:The reasons explaining why some patients exhibit higher monosodium urate (MSU) crystal burdens than others remain largely unknown. While MSU crystal formation is enhanced by certain factors in vitro such as pH, temperature, and other ion concentrations, it is currently unknown whether comorbidities and clinical features are associated with increased MSU deposition in vivo.Objectives:To determine which factors are associated with the burden of MSU crystal deposition quantified by dual-energy CT (DECT) in urate lowering therapy (ULT)-naive gout patients.Methods:In this multicenter cross-sectional study, DECT scans of knees and feet were prospectively obtained from ULT-naive, or not taking any ULT for more than a year, gout patients. Demographic, clinical (including gout history and comorbidities), and biological data were collected, and their association with DECT MSU crystal volume was analyzed using bivariate and multivariate analyses. A second bivariate analysis was performed by splitting the dataset depending on an arbitrary threshold of DECT MSU volume (1 cm3).Results:A total of 125 gout patients were included, of whom 91 underwent both DECT scans of knees and feet. In bivariate analysis, age (p=0.03), symptom duration (p=0.003), subcutaneous tophi (p=0.004), hypertension (p=0.02), diabetes mellitus (p=0.05), and chronic heart failure (p=0.03) were associated with the total DECT volume of MSU crystal deposition. In multivariate analysis, factors associated with DECT MSU volumes ≥1 cm3 were gout duration (OR for each 10-year increase 3.15 [1.60;7.63]), diabetes mellitus (OR 4.75 [1.58;15.63]), and chronic heart failure (OR 7.82 [2.29;31.38]). The model performance was good with an AUC of 0.816.Conclusion:Specific comorbidities, particularly chronic heart failure, diabetes mellitus, and hypertension, are more strongly associated with increased MSU crystal deposition in knees and feet than gout duration, regardless of serum urate level.Disclosure of Interests: :Tristan Pascart Grant/research support from: Research Grant Horizon Pharma, Consultant of: Novartis, BMS, Sanofi, Pfizer,, Speakers bureau: Novartis, BMS, André Ramon: None declared, Sebastien Ottaviani: None declared, Julie Legrand: None declared, Vincent Ducoulombier: None declared, Eric Houvenagel Speakers bureau: Janssen, Novartis, Laurène Norberciak: None declared, Pascal Richette: None declared, Fabio Becce: None declared, Paul Ornetti: None declared, Jean-François Budzik: None declared

scholarly journals OP0175 IDENTIFYING PERIPHERAL VASCULAR MONOSODIUM URATE CRYSTAL DEPOSITION WITH DUAL-ENERGY CT: FACT OR FICTION? THE VASCURATE STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 109.2-109
Author(s):  
T. Pascart ◽  
P. Carpentier ◽  
L. Norberciak ◽  
J. Legrand ◽  
E. Houvenagel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Longitudinal Study ◽  
Soft Tissues ◽  
Dual Energy ◽  
Monosodium Urate ◽  
Peripheral Vascular ◽  
Crystal Deposition ◽  
Lowering Therapy ◽  
Crystal Volume

Background:The close relationship between gout and cardiovascular diseases is well established. A growing hypothesis explaining this association would be that monosodium urate (MSU) crystals are deposited within vessel walls. Dual-energy computed tomography (DECT) can identify and quantify MSU crystal deposition in soft tissues. It remains unclear whether vascular spots exhibiting DECT attenuation characteristics of MSU are artefacts or true MSU crystal deposits.Objectives:The objectives of this study were to determine whether the presence of peripheral vascular MSU crystal deposition identified with DECT is associated with the extent of MSU deposits in joint soft tissues, and if this association persists over time under urate-lowering therapy.Methods:Patients with a clinical suspicion or established gout diagnosis prospectively underwent DECT for identification and quantification of the MSU crystal burden in their knees and feet. Some of these patients were also enrolled in the GOUT-DECTUS longitudinal study, and thus underwent follow-up DECT scans of their knees and feet at 6, 12 and 24 months. DECT scans were examined for the presence of vascular spots ≥0.01 cm3 classified as MSU crystal deposits according to the default post-processing settings. Multiple linear regressions adjusting on serum urate levels and gout diagnosis were implemented to determine the association between DECT MSU crystal volume in joint soft tissues, and the presence of vascular MSU deposits. Mixed linear models were used to compare DECT volumes of MSU crystal deposition in soft tissues between vascular MSU positive and negative patients during follow-up.Results:A total of 169 patients were included, of which 140 had a final diagnosis of gout, including 15 also included in the longitudinal study. Patients were mostly male (78.8%) and were 65.5 ± 14.6 years old. Among gout patients, disease duration was 9.3 ± 9.9 years and 56.5% were urate lowering therapy-naive. A total of 11/29 (37.9%) controls and 40/140 (28.6%) gout patients presented with a least one vascular spot of DECT MSU deposition, with an average volume of 0.02 ± 0.02 cm3, and all subjects also presented at least one vascular calcification. In the feet, patients positive for vascular DECT MSU crystal deposition had an MSU volume of 3.81 ± 10.06 cm3 in joint soft tissues, compared with 1.85 ± 7.72 cm3 for those without vascular MSU deposition (p=0.018). In the knees, patients with vascular MSU deposition had an MSU crystal volume of 6.03 ± 24.13 cm3 in joint soft tissues, compared with 0.83 ± 2.88 cm3 for those without vascular evidence of MSU deposition. In the longitudinal subgroup analysis, coefficients of the fixed effects for the presence of vascular MSU deposits on the MSU crystal volume in joint soft tissues was 0.4 (p=0.35) in the feet and 1.21 (p=0.03) in the knees. The presence of vascular DECT MSU deposits was associated with a 3.4-fold increase in MSU crystal volume in knee joint soft tissues throughout follow-up.Conclusion:This study suggests that some vascular spots identified with DECT as MSU crystal deposition may be real and not artefacts. This correlation remains throughout follow-up in the knees. However, the comparable prevalence of vascular DECT MSU deposits between gout patients and controls, the systematic co-existence of vascular calcifications and the uneven regression under urate-lowering therapy requires further analysis to determine which DECT spots are artefacts and which are not.References:[1]Dual-Energy Computed Tomography Detection of Cardiovascular Monosodium Urate Deposits in Patients With Gout. Klauser AS, Halpern EJ, Strobl S, Gruber J, Feuchtner G, Bellmann-Weiler R, Weiss G, Stofferin H, Jaschke W.Disclosure of Interests:Tristan Pascart Grant/research support from: Research Grant Horizon Pharma, Consultant of: Novartis, BMS, Sanofi, Pfizer,, Speakers bureau: Novartis, BMS, Paul Carpentier: None declared, Laurène Norberciak: None declared, Julie Legrand: None declared, Eric Houvenagel Speakers bureau: Janssen, Novartis, Fabio Becce: None declared, Jean-François Budzik: None declared

TO EVALUATE DECT’S ROLE IN GOUT AND EXAMINE THE RELATIONSHIP WITH CLINICAL AND PARACLINICAL

2019 ◽  
pp. 78-83
Author(s):  
Van Nam Tran ◽  
Tam Vo ◽  
Chi Cuong Nguyen ◽  
Nguyen Thanh Nhan Vo ◽  
Thanh Hai Phan
Keyword(s):  
Computed Tomography ◽  
Bone Structure ◽  
Multivariate Logistic Regression Analysis ◽  
Dual Energy ◽  
Original Research ◽  
Cross Sectional ◽  
Crystal Deposition ◽  
Dual Energy Computed Tomography ◽  
The Relationship ◽  
Urate Crystals

Background: To identify Urate crystals from synovial fluid under polarized microscopy is considered the gold standard in diagnosing Gout disease. However, it is not always possible to suck up enough fluid or in case of pain, it is impossible to suck the fluid. Dual-energy Computed Tomography (DECT) is a new tool for diagnosing Gout disease. DECT shows the deposition of urate crystals and bone structure images using different display colors. However, there is no agreement from the research results in the world. In Vietnam, no original research has been published. Objective: To evaluate DECT’s role in Gout and examine the relationship with clinical and paraclinical factors. Methods: A cross-sectional study was conducted in patients who visited the Hoa Hao-Medic clinic in Ho Chi Minh City. Gout disease is diagnosed with clinical and paraclinical criteria; and have DECT results. The cases were selected continuously, there were no cases of losing samples. Multivariate logistic regression analysis was used to determine the independent association between clinical and paraclinical variables with DECT images. Results: 61 out of 80 Gout patients with DECT positive accounted for 77.25%, There was an association between DECT and number of Gout attacks (> 3 times), duration of illness (> 36 months), tophi seeds. No correlation was found between clinical variables and background characteristics in the study. In the subclinical, urate crystal deposition images show a clear imprint on goute disease, while other variables do not find expression. Conclusion: DECT is closely related to the frequency of gout attacks, disease duration and tophi. Gout disease is a consequence of lifestyle behaviors, inappropriate eating habits, and exposure to risk factors in life. Key words: DECT (Dual-energy Computed Tomography), Hoa Hao-Med, Gout

Monosodium Urate Crystal Deposition in Coronary Artery Plaque by 128-Slice Dual-Energy Computed Tomography

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gudrun M. Feuchtner ◽  
Fabian Plank ◽  
Christoph Beyer ◽  
Christoph Schwabl ◽  
Julia Held ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Dual Energy ◽  
Monosodium Urate ◽  
Crystal Deposition ◽  
Coronary Artery Plaque ◽  
Dual Energy Computed Tomography ◽  
Urate Crystal

Correlation Between Functional Health Literacy and Self-efficacy in People with Type 2 Diabetes Mellitus: Cross-sectional Study

2021 ◽  
pp. 105477382110068
Author(s):  
Luis Angel Cendejas Medina ◽  
Renan Alves Silva ◽  
Magda Milleyde de Sousa Lima ◽  
Lívia Moreira Barros ◽  
Rafael Oliveira Pitta Lopes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Functional Health ◽  
Bivariate Analysis ◽  
Sectional Study ◽  
Cross Sectional

To analyze the correlation between functional health literacy (FHL) and self-efficacy (SE) in people with type 2 Diabetes Mellitus. Cross-sectional study was conducted among September and October 2019, with 196 people with type 2 diabetes. Data were collected using the Functional Literacy in Health instrument (B-TOFHLA) and the Diabetes Management Self-Efficacy Scale for Patients with Type 2 Diabetes Mellitus (DMSES). Bivariate analysis was used to verify the relationship among the constructs. Most diabetics showed an average B-TOFHLA score of 74.75, considered adequate, and self-efficacy of 4.07, high. The association between SE and FHL in the bivariate analysis found no statistical significance ( p > .05), in the same sense as the B-TOFHLA score and the DMSES domains ( p > .05). Constructs were not related to each other in terms of skills arising from judgments and decisions with motivational confidence by the investigated audience.

Sign in / Sign up

Export Citation Format

Share Document