Increased visceral fat accumulation further aggravates the risks of insulin resistance in gout

We performed the present study to determine the degree of visceral fat accu mulation and incidence of visceral fat obesity in 138 gout patients who wer e classified as overexcretion type (n = 53) and underexcretion type (n = 85 ) by their levels of uric acid clearance and urinary uric acid excretion. W e also investigated the relationship between visceral fat accumulation and insulin resistance expressed by the homeostasis model assessment (HOMA) ind ex. Visceral fat area (VFA)/surface body area (SBA) was significantly incre ased in patients with gout as compared with control subjects (79.7 +/- 30.8 cm(2)/m(2) v 65.1 +/- 24.1 cm(2)/m(2), P < .001). It was also shown that V FA/SBA in the gout overexcretion group was significantly increased as compa red with the gout underexcretion group (88.3 <plus/minus> 32.8 cm(2)/m(2) v 74.3 +/- 28.3 cm(2)/m(2), P < .01). Although the incidence of visceral fat obesity (VFO) was not different between gout patients and control subjects , the incidence of VFO was significantly higher in the gout overexcretion t ype than the gout underexcretion type (19 of 53 v11 of 85, P < .01). Furthe r, there was a significant relationship between visceral fat area and HOMA index. Gout patients possess some factors that are included in the insulin resistance syndrome, irrespective of the presence of VFO, and the insulin r esistance risk factors observed in gout become more prominent when it is co mplicated with VFO. Our results suggest that gout patients, especially the overexcretion type who have greater levels of visceral fat accumulation, ma y be more vulnerable to atherosclerotic diseases. Copyright (C) 2001 by W.B . Saunders Company.