Changes in Lipidome of Hyperuricemic and Gout Patients Has Significant Effect on Lipid Metabolism

“Currently, it is not possible to predict whether patients with hyperuricemia (HUA) will develop gout and how this progression may be affected by urate-lowering treatment (ULT),” investigators of a study in Arthritis Research & Therapy wrote. Therefore, the team examined the differences in plasma lipidome among individuals with HUA and gout, stratified by age, and compared with normouricemic healthy controls.

The study involved 94 asymptomatic HUA subjects (77% ≤40 years), 196 gout patients (59% ≤40 years), and 53 normouricemic healthy controls. Plasma samples were collected from each group, and a comprehensive targeted lipidomic analysis was conducted to semi-quantify 608 lipids. Univariate and multivariate statistical analyses were employed, along with advanced visualizations to discern patterns in lipid profiles.

The most notable changes included an upregulation of phosphatidylethanolamines and a downregulation of lysophosphatidylcholine plasmalogens/plasmanyls. These lipidomic changes were more profound in individuals with HUA and gout onset before the age of 40 years, particularly those without ULT.

Multivariate statistics demonstrated a high accuracy (>95%) in differentiating between HUA and gout patients and normouricemic healthy controls based on their lipidomic profiles.

The authors of the study noted several limitations—first, the imbalances in sex and age distribution among control and patient groups, although efforts were made to account for these differences. They also acknowledged other factors which may have affected the results, including the exclusive inclusion of white participants; absence of information on alcohol intake; limitations in the structural identification of lipids, particularly in determining the position and stereochemistry of double bonds; and the inability to analyze every lipid class present in plasma due to technological constraints.

“ULT had a significant effect on the normalization of lipid profiles, especially on HUA ≤40 [years] patients, while in groups >40 years, this trend was not evident,” the authors wrote in conclusion. “The benefits of early initiation of ULT in early-onset hyperuricemia patients require careful analysis.”