Clinical Research

To investigate the association between gout⁃related gene polymorphisms and clinical phenotypic heterogeneity in gout patients from the Foshan region

  • Qihong GUO ,
  • Baolin ZHENG ,
  • Ting LI ,
  • Yutong JIANG ,
  • Junli CHEN ,
  • Yuanyi LI ,
  • Haimei YANG ,
  • Junguang. LU
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  • *.Department of Rheumatology and Immunology,the Eighth Clinical Medical College of Guangzhou University of Chinese Medicine,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China

Received date: 2025-07-23

  Online published: 2025-10-10

Abstract

Objective To investigate the association between gout-related gene polymorphisms and clinical phenotypic heterogeneity among gout patients in the Foshan region, thereby providing a scientific basis for stratified clinical management. Methods A total of 125 gout patients diagnosed at the Foshan Hospital of Traditional Chinese Medicine between June 2022 and May 2025 were enrolled in this study. The collected data included demographic characteristics, frequency of gout attacks, presence of tophi, levels of uric acid, creatinine, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), gout-related genes (ABCG2SLC2A9SLC22A12MTHFR), and joint ultrasound findings. Group comparisons and rank correlation analyses were conducted to explore potential associations between gene polymorphisms and clinical heterogeneity. Results The male-to-female ratio was 11∶1; the mean age was (35.28 ± 2.67) years; the mean disease duration was (6.03 ± 0.68) years; and the mean frequency of acute attacks in the past 12 months was 4 (2.0, 7.25). Genotype distributions were as follows: ABCG2: wild-type (C/C), 23.8%; heterozygous (C/A), 53.2%; homozygous (A/A), 23%. SLC2A9: wild-type (A/A), 24.6%; heterozygous (A/G), 50%; homozygous (G/G), 25.4%. SLC22A12: wild-type (A/A), 4.8%; heterozygous (A/C), 31.7%; homozygous (C/C), 63.5%. MTHFR: wild-type (C/C), 68.3%; heterozygous (C/T), 28.6%; homozygous (T/T), 3.2%. Rank correlation analysis revealed that SLC2A9 polymorphisms were significantly correlated with tophi formation (ρ = 0.193, P = 0.031) and crystal deposition on ultrasound (ρ = 0.202, P = 0.025). SLC22A12 polymorphisms were associated with hypertension (ρ = 0.269, P = 0.003) and diabetes (ρ = 0.200, P = 0.026). MTHFR polymorphisms showed a correlation with diabetes (ρ = 0.224, P = 0.012). Conclusions Polymorphisms in SLC2A9SLC22A12, and MTHFR are significantly linked to clinical phenotypic heterogeneity among gout patients. Genetic testing could facilitate the early identification of individuals at high risk for complications and support the development of stratified and individualized treatment approaches.

Cite this article

Qihong GUO , Baolin ZHENG , Ting LI , Yutong JIANG , Junli CHEN , Yuanyi LI , Haimei YANG , Junguang. LU . To investigate the association between gout⁃related gene polymorphisms and clinical phenotypic heterogeneity in gout patients from the Foshan region[J]. The Journal of Practical Medicine, 2025 , 41(19) : 3060 -3064 . DOI: 10.3969/j.issn.1006-5725.2025.19.015

References

[1] SINGH J, GAFFO A. Gout epidemiology and comorbidities[J]. Semin Arthritis Rheum, 2020, 50(3S):S11-S16. doi:10.1016/j.semarthrit.2020.04.008
[2] KIM J, KWAK S, LEEE H, et al. Prevalence and incidence of gout in Korea: Data from the national health claims database 2007-2015[J]. Rheumatol Int, 2017, 37(9):1499-1506. doi:10.1007/s00296-017-3768-4
[3] ZHU Y, PANDYA B, CHOI H. Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007-2008[J]. Arthritis Rheum, 2011, 63(10):3136-3141. doi:10.1002/art.30520
[4] GBD 2021 Gout Collaborators. Global, regional, and national burden of gout, 1990-2020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021[J]. Lancet Rheumatol, 2024, 6(8):e507-e517.
[5] YUAN J S J, SHASHIDHARA A, SUTARIA A, et al. An update on the pharmacotherapy of gout[J]. Expert Opin Pharmaco, 2025, 26(1):101-109. doi:10.1080/14656566.2024.2442028
[6] ASGHARI K M, ZAHMATYAR M, SEYEDI F, et al. Gout: Global epidemiology, risk factors, comorbidities and complications: A narrative review[J]. BMC Musculoskelet Disord, 2024, 25(1):1047. doi:10.1186/s12891-024-08180-9
[7] CAED-GOWERS J, RETAT L, KUMAR A, et al. Projected Health and Economic Burden of Comorbid Gout and Chronic Kidney Disease in a Virtual US Population: A Microsimulation Study[J]. Rheumatol Ther, 2024, 11(4):913-926. doi:10.1007/s40744-024-00681-2
[8] KOO B S, JEONG H J, SON C N, et al. Relationship Between Chronic Kidney Disease and Serum Uric Acid Levels: A Cross-sectional Study on the Korean Population[J]. J Rheum Dis, 2021, 28(4):225-233. doi:10.4078/jrd.2021.28.4.225
[9] FITZGERALD J D, DALBETH N, MIKULS T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout[J]. Arthritis Care Res (Hoboken), 2020, 72(6):744-760. doi:10.1002/acr.24180
[10] LORENZO J P P, SOLLANO M H M Z, SALIDO E O, et al. 2021 Asia-Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout[J]. Int J Rheum Dis, 2022, 25(1):7-20. doi:10.1111/1756-185x.14266
[11] LI C, LU J, LYU Z, CHEN H, et al. Clinical Practice Consensus Statement 2025: Management of Hyperuricemia and Gout in Adolescents[J]. Int J Rheum Dis, 2025, 28(7):e70378. doi:10.1111/1756-185x.70378
[12] LI Y, CHEN Z, XU B, et al. Global, regional, and national burden of gout in elderly 1990-2021: An analysis for the global burden of disease study 2021[J]. BMC Public Health, 2024, 24(1):3298. doi:10.1186/s12889-024-20799-w
[13] 徐东, 朱小霞, 赵岩, 等. 痛风诊疗规范[J]. 中华内科杂志, 2023, 62(9):1068-1076.
[14] PASCART T, DUCOULOMBIER V, JAUFFRET C. Early-onset gout[J]. Jt. Bone Spine, 2024, 91(5):105704. doi:10.1016/j.jbspin.2024.105704
[15] 张新蕾. ABCG2功能性单核苷酸多态性与痛风及高尿酸血症的相关性研究及职工高尿酸血症队列建立[D]. 北京:北京协和医学院, 2014.
[16] ECKENSTALER R, BENNDORF R A. The Role of ABCG2 in the Pathogenesis of Primary Hyperuricemia and Gout-An Update[J]. Int J Mol Sci, 2021, 22(13):6678. doi:10.3390/ijms22136678
[17] SHAFIU M, JOHNSON R J, TURNER S T, et al. Urate transporter gene SLC22A12 polymorphisms associated with obesity and metabolic syndrome in Caucasians with hypertension[J]. Kidney Blood Press Res, 2012, 35(6):477-482. doi:10.1159/000337370
[18] REGINGINATO A M, MOUNT D B, YANG I, et al. The genetics of hyperuricaemia and gout[J]. Nat Rev Rheumatol, 2012, 8(10):610-621. doi:10.1038/nrrheum.2012.144
[19] 于飞, 叶丛, 涂巍, 等. 影响痛风患者降尿酸治疗疗效的因素分析[J]. 中华风湿病学杂志, 2017, 21(2):110-113.
[20] DUONG N T, NGOC N T, THANG N T M, et al. Polymorphisms of ABCG2 and SLC22A12 Genes Associated with Gout Risk in Vietnamese Population[J]. Medicina (Kaunas), 2019, 55(1):8. doi:10.3390/medicina55010008
[21] VANDERPOL K H, NIJENHUIS M, SOREE B, et al. Dutch pharmacogenetics working group guideline for the gene-drug interaction of ABCG2, HLA-B and Allopurinol, and MTHFR, folic acid and methotrexate[J]. Eur J Hum Genet, 2024, 32(2):155-162. doi:10.1038/s41431-022-01180-0
[22] DALBETH N, GOSLING A L, GAFFO A, et al. Gout[J]. Lancet, 2021, 397(10287):1843-1855. doi:10.1016/s0140-6736(21)00569-9
[23] TAO H, MO Y, LIU W, et al. A review on gout: Looking back and looking ahead[J]. Int Immunopharmacol, 2023, 117:109977. doi:10.1016/j.intimp.2023.109977
[24] STIBURKOVA B, PAVLIKOVA M, SOKOLVA J, et al. Metabolic syndrome, alcohol consumption and genetic factors are associated with serum uric acid concentration[J]. PLoS One, 2014, 9(5):e97646. doi:10.1371/journal.pone.0097646
[25] YANG X, LAN Q, WANG Q, et al. Association of homocysteine and uric acid with type 2 diabetes mellitus: A case-control study[J]. Sci Rep, 2025, 15(1):1914. doi:10.1038/s41598-025-85812-7
[26] KEYBER G, DIE G, PATHOGENESE D. Gout arthritis: Pathogenesis, diagnostics and treatment[J]. Dtsch Med Wochenschr, 2020, 145(14):991-1005.
[27] CAIY, LIU B, ZHANG Y, et al. MTHFR gene polymorphisms in diabetes mellitus[J]. Clin Chim Acta, 2024, 561:119825. doi:10.1016/j.cca.2024.119825
[28] YANAI H, ADACHI H, HAKOSHIMA M, et al. A Possible Therapeutic Application of the Selective Inhibitor of Urate Transporter 1, Dotinurad, for Metabolic Syndrome, Chronic Kidney Disease, and Cardiovascular Disease[J]. Cells, 2024, 13(5):450. doi:10.3390/cells13050450
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