Antyuk Z. Clinical and pathogenetic variants, prevention and treatment of metabolic disorders of gout

Object of research is metabolic changes in case of gout; goal is improving the treatment of patients with gout based on the study of clinical and pathogenetic features of the disease course, the characteristics of metabolic changes and stratification of cardiovascular risk factors (CV-risk) and development of complex differential treatment using telmisartan , fenofibrate in combination with Omega -3 eicosanoic fatty acids (Omega-3 EFAs); methods are general and clinical, instrumental , biochemical , statistical , novelty and results are that clinical and laboratory features of the course of gout in combination with metabolic syndrome (MS) are defined for the first time; examining the state of cardiac markers of patients with gout and MS allowed to find out levels of metabolic disorders in details as well as to identify the interrelation between the individual components of MS; connection of basic parameters of MS and severity of difficulty of arthralgic status on the conditions of availability of comorbid pathology of patients with gout are demonstrated; further improvement got the concept of determining factors and pathogenic mechanisms of systemic inflammation formation in case of gout associated with MS; the interrelation between markers of systemic inflammation and the intensity of clinical and functional manifestations of patients with gout is first established, role of MS in increasing CV-risk in this cohort of patients is proven; it is demonstrated that on the background of the use of telmisartan reliable positive trend towards lowering uric acid is observed, it is found that long-term use of telmisartan can achieve blood pressure control of patients with gout in combination with MS; the effectiveness of fenofibrate and combination of fenofibrate with Omega 3 EFAs of patients with refractivity to monotherapy using fenofibrate is first proven, it is grounded that an adequate hipouricemic therapy combined with correction of blood pressure and dyslipidemia , along with improvement of clinical symptoms, leads to positive dynamics of the main indicators of MS and reduces CV-risk; it is introduced in clinical practice of rheumatologic department of Municipal Institution of Ternopil Regional Council "Ternopil University Hospital", therapeutic departments of Buchach, Kozova district hospitals in the region, Ternopil City Hospital No 3, in the educational process of Bukovyna , Ivano -Frankivsk, Ternopil Medical University; the field of use is diagnostic and treatment process of rheumatologic, cardiac and therapeutic departments, scientific and pedagogical processes of therapeutic profile departments of medical institutions.