PT  - JOURNAL ARTICLE
AU  - Fatima K. Alduraibi
AU  - Mohammad Saleem
AU  - Karina Ricart
AU  - Rakesh P. Patel
AU  - Alexander J. Szalai
AU  - Jasvinder A. Singh
TI  - Clustering Patients With Gout Based on Comorbidities and Biomarkers: A Cross-Sectional Study
AID  - 10.3899/jrheum.220635
DP  - 2022 Dec 15
TA  - The Journal of Rheumatology
PG  - jrheum.220635
4099  - http://www.jrheum.org/content/early/2023/01/25/jrheum.220635.short
4100  - http://www.jrheum.org/content/early/2023/01/25/jrheum.220635.full
AB  - Objective This single-center clinical study identifies clusters of different phenotypes and pathophysiology subtypes of patients with gout and associated comorbidities. Methods Patients clinically diagnosed with gout were enrolled between January 2018 and December 2019. Hierarchical cluster analyses were performed using clinical data or biological markers, inflammatory markers, and oxidative stress pathway metabolites assayed from serum and plasma samples. Subgroup clusters were compared using ANOVA for continuous data and chi-square tests for categorical data. Results Hierarchical cluster analysis identified 3 clusters. Cluster 1 (C1; n = 24) comprised dyslipidemia, hypertension, and early-onset gout, without tophi. Cluster 2 (C2; n = 25) comprised hypertension, dyslipidemia, nephrolithiasis, and obesity. Cluster 3 (C3; n = 39) comprised multiple comorbidities and tophi. Post hoc comparisons of data obtained from samples of patients in C1, C2, and C3 revealed significant differences in the levels of oxidative stress and inflammation-related markers, including 3-nitrotyrosine, tumor necrosis factor, C-reactive protein, interleukin (IL) 1β, IL-6, platelet-derived growth factor (PDGF)–AA, and PDGF-BB. Reclustering patients based on all markers as well as on the biological markers that significantly differed among the initial clusters identified similar clusters. Conclusion Oxidative stress and inflammatory marker levels may affect the development and clinical manifestations (ie, clinical phenotypes) of gout. Measuring oxidative stress and levels of inflammatory cytokines is a potential adjunctive tool and biomarker for early identification and management of gout.