To determine clinical significance of laboratory markers of vascular endothelium activation in gout.
A total of 16 males aged 31-68 years with gout entered the study. The diagnosis satisfied Vallas' criteria, duration of the disease varied from 1.5 to 14 years. Six (37%) patients had chronic gouty arthritis, ten (63%) patients were in the attack-free period. All the patients had metabolic syndrome, 7 (43.7%) of them suffered from diabetes mellitus type 2. Arterial hypertension was diagnosed in 12 (75%) patients. Thickness of the intima-media complex (IMC) of the carotid arteries was measured in 12 patients with duplex ultrasonic scanning. Solid phase enzyme immunoassay studied serum concentrations of a soluble form VCAM-1 (sVCAM-1) and von Willebrand factor antigen (WF:Ag) as laboratory markers of endothelial activation. The above immunoassay was also used to study acute phase inflammatory changes by the levels of C-reactive protein (CRP).
Concentration of sVCAM-1 in gout was 1385.2 +/- 341.0 ng/ml and was significantly higher than in the control group (p < 0.001). Mean values of WF:Ag and CRP in the serum were also significantly higher in the study group. The levels of both sVCAM-1 and WF:Ag were elevated in 25% patients. CRP was elevated (8 mg/l) in 6 (37.5%) patients. They had no infectious complications and age-, duration- and stage-related specific features of the disease. There was no significant differences between mean levels of sVCAM-1, WF:Ag, CRP in patients with diabetes mellitus and metabolic syndrome. There was no correlation between uric acid level and IMC thickness (r = 0.12; p > 0.05). A weak positive insignificant correlation was found between concentration of CRP, sVCAM-1 and IMC thickness of the carotid arteries (r = 0.28 and r = 0.36, respectively; p > 0.05). However, this index significantly correlated with WF:Ag(r = 0.62; p < 0.05). A moderate positive but insignificant correlation was detected between the levels of sVCAM-1 and WF:Ag (r = 0.47; p > 0.05). Concentration of sVCAM-1 weakly correlated with that of CRP (r = 0.35; p > 0.05). WF:Ag and CRP levels correlated significantly (r = 0.51; p < 0.05).
Increased concentrations of sVCAM-1 and WF:Ag in gout reflect not only activation of vascular endothelium but also development of atherosclerotic process in these patients.