Homocysteine Levels Elevated in Gout Patients

Also an inverse association between serum Hcy levels and renal function.
Also an inverse association between serum Hcy levels and renal function.

Elevated serum homocysteine (Hcy) levels are associated with decreased renal function, but not with serum uric acid levels, according to a new study.

Researchers at Chung-Ang University College of Medicine in Seoul compared 91 men with gout and 97 age-matched healthy male controls. Serum uric acid levels did not differ significantly between the two groups, possibly because most of the gout patients enrolled in the study were treated with uric-acid lowering medications, the investigators, led by Jung-Soo Song, MD,  reported in the Journal of Korean Medical Science (2014;29:788-792). Serum Hcy levels, however, were significantly higher in the gout patients compared with controls (13.96 vs. 12.67 μM/L).

In the gout group, patients with stage 1-2 chronic kidney disease (CKD) had significantly lower serum Hcy than those with stage 3-5 CKD (13.15 vs. 17.45 μM/L). Multivariate analysis demonstrated an inverse association between serum Hcy and estimated glomerular filtration rate.

Dr. Song's group explained that both hyperhomocysteinemia and gout are associated with cardiovascular disease (CVD), but the precise nature of the relationship has been unclear. “Our results suggest that hyperhomocysteinemia can be one of the potential triggers of increased CVD risk in patients with chronic gout, especially if their uric acid levels are not elevated,” the investigators wrote.

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