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Gout Associated With Elecated Apolipoprotein/ Reduced Urate Excretion

Reduced renal excretion of uric acid among patients with gout is mediated by high levels of very low-density lipoprotein (VLDL), combined with a high prevalence of the E2 allele of apolipoprotein E.

This finding is the result of a study of 68 patients with gout, and 50 matched healthy controls, by clinicians at Endocrinology and Nutrition Service, Hospital Civil, Malaga and. Servicio de Reumatologia, Hospital Reina Sofia, Cordoba, Spain.

Earlier studies have shown that lower renal excretion of urates among patients with hyperuricaemia is inversely related to plasma VLDL levels, and that the different genotypes of the apolipoprotein E gene are related to the plasma levels of lipids. The clinicians aimed to determine the prevalence of apolipoprotein E in hyperuricaemic patients, as well as investigating whether the renal excretion of urates is conditioned by the apoliprotein E genotype.

Plasma levels of lipoproteins, cholesterol, triglycerides and uric acid, and the renal excretion of uric acid were assessed among gout patients and controls. Both groups were genotyped for apolipoprotein E by means of an amplification technique and inverse hybridization.

The E2 allele was more prevalent among the grout patients than among the controls. Levels of cholesterol, triglycerides and uric acid were greater among the gout patients, in contrast to a lower prevalence of high-density lipoprotein.

The patients with the E2 allele had higher levels of triglycerides in VLDL and intermediate-density lipoproteins, and a lower renal excretion of urates, the researchers found.
Rheumatology (Oxford) 2003 Mar;42:3:468-72. "The elevated prevalence of apolipoprotein E2 in patients with gout is associated with reduced renal excretion of urates"

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