Expression Of Endothelin, Nitric Oxide And Myeloperoxidase In Gout

Objective: Gout was a kind of inflammatory disease, which wascharacteristed of increased blood uric acid caused by disorder of purinemetabolism. As the diet structure changed, the incidence of hyperuricemia andgout rised year by year. In recent years, the relationship between gout andcoronary heart disease had become a research hotspot. The aim of this studywas to investigate the function of vascular endothelium in gout patientsthrough detected the serum levels of endothelin, nitric oxide,myeloperoxidase，to research the risk of coronary heart disease with gout.Methods:54male gout patients of and23male normal controls aged over20were chosen. All of the patients corresponded the modified criteria for goutby American College Of Rheumatology (ACR), which identified acute goutyarthritis classification standard in1977, except secondary gout, diabetes,hypertension, ever hyperlipemia, cardiovascular disease, connective tissuediseases or autoimmune disease. The serum levels of ET, NO and MPO weredetermined by avidin biotin peroxidase complex enzyme-linkedimmunosorbent assay (ABC-ELISA). The clinical data of gout patients werecollected such as blood uric acid, body mass index(BMI), blood lipid (TC,TG, HDL, LDL), erythrocyte sedimentation rate (ESR), C-reactive protein(CRP), creatinine(Crea), blood urea nitrogen (BUN), calcium (Ca),phosphorus (P), etc. The levels of endothelin, nitric oxide, myeloperoxidase ofgout patients were compared with normal controls. Gout patients wereclassified into two groups according to the value of ESR or CRP:inflammatory group and non inflammatory group. The data were comparedbetween these two groups. The correlation were analyzed between betweenabove mentioned indicates and laboratory parameters.All the data were analyzed by SPSS17.0for Windows statistical software. The mean number±standard deviation (x±s) was used to express themeasurement data. The t or t’ test was adopted for comparison betweengroups. Linear correlation analysis was performed for correlationship. Pvalue<0.05was considered significant.Results:1The demographic details:1.1The study group comprised54male gout patients. The mean age was(45.96±11.75) yr (range23to71years). The normal control comprised23male subjects. The mean age was (38.73±12.06) yr (range21to65years).There was no significant difference between the gout group and control groupin age and gender (P>0.05).2The levels of indicates related to function of vascular endothelial2.1The serum levels of ET in gout group were significant higher than normalcontrols (mean±SD,47.30±11.81vs.36.68±9.32mmol/L, respectively；P=0.000).2.2The serum levels of NO in gout group were significant lower than normalcontrols (mean±SD,42.48±10.94vs.49.62±14.07mmol/L, respectively；P=0.019).2.3The serum level of MPO in gout group was significantly higher (P<0.05)than normal controls (mean±SD,0.248±0.054vs.0.194±0.044mmol/L,respectively；P=0.000).3According to the value of ESR or CRP, the inflammatory group comprised37male gout patients. The mean age was (44.03±12.32) yr (range23to71years). The non inflammatory group comprised17male gout patients. Themean age was (50.18±9.41) yr (range30to70years). There was no significantdifference between the two groups in age and gender (P>0.05). There was nosignificant difference between the two groups in the serum level of NO, ET,MPO (P>0.05).4The correlation between ET, NO, MPO and clinical parameters4.1The serum level of NO was negatively correlated with ET (r=-0.296,P=0.009). The serum level of ET was positively correlated with MPO (r=0.352, P=0.002). There was no significant correlation between NO andMPO.4.2The serum level of NO was negatively correlated with blood uric acid(r=-0.411, P=0.002). The serum level of ET and MPO was positivelycorrelated with blood uric acid (r=0.405，P=0.002；r=0.339，P=0.012). Theserum level of NO was negatively correlated with BUN (r=-0.392，P=0.003).There was no significant correlation between NO and other clinicalparameters.The serum level of MPO was positively correlated with BMI, LDLand BUN (r=0.274，P=0.045；r=0.343，P=0.011；r=0.357，P=0.008). Therewas no significant correlation between MPO and other clinical parameters.Theserum level of ET was positively correlated with TC and BUN (r=0.274，P=0.045；r=0.291，P=0.033). There was no significant correlation between ETand other clinical parameters.4.3The serum level of blood uric acid was negatively correlated with HDL(r=-0.296, P=0.030). The serum level of blood uric acid was positivelycorrelated with BMI, TC, TG, LDL and BUN (r=0.298, P=0.029; r=0.365,P=0.007; r=0.359, P=0.008; r=0.286, P=0.036; r=0.416, P=0.002). There wasno significant correlation between blood uric acid and other clinicalparameters.Conclusions:1. There were high level ET, MPO and low level NO in gout patients. Itindicated disfunction of vessel endothelium in gout patients.2. The serum levels of ET, MPO and NO were related with the levels of blooduric acid and blood fat in gout patients. The abnormalities of blood uric acidand blood fat maybe were the biochemical initiating agent of the damage ofthe endothelial function.3. The serum levels of ET, MPO and NO were not related with theinflammation status of gout patients. It suggests inflammation did not play animportant role in the damage of the endothelial function.4. The risk of cardiovascular disease and cerebrovascular disease increased ingout patients.