EFFICIENCY OF BIOFLAVONOIDS IN THE TREATMENT OF PATIENTS WITH GOUT ON THE BACKGROUND OF METABOLIC SYNDROME

The aim of the study was to evaluate the effectiveness of the use of bioflavonoid quercetin in patients with gout on the background of metabolic syndrome. Object and research methods. Sixty-one patients with primary gout in combination with metabolic syndrome were examined. All patients were male with an average age of 53.4±5.9 years. The average duration of gout was 7±1.9 years. Criteria for inclusion in the study: primary gout, x-ray stage 2-3, the degree of functional insufficiency I-II, the presence of metabolic syndrome. Exclusion criteria: secondary gout, endocrine pathology, chronic kidney disease 3-5 stage. All patients were divided into two groups - the first - the main (n = 30) and the second - the comparison group (n = 31). In the main group allopurinol was admin-istered (initial dose of 100 mg per day, followed by titra-tion of the dose to a maintenance dose of 300 mg per day to achieve the target uric acid level of less than 360 mmol / l) and quertin 40 mg, 1 tablet 3 times a day for 6 months, with a repetition of the course after 2-3 months. In comparison group, only allopurinol was administered (initial dose of 100 mg per day, followed by dose titra-tion). The treatment regimen was prescribed during the period of remission. Efficiency assessment was carried out after 12 and 24 months. All patients were subjected to anamnesis, physi-cal examination, blood pressure measurement, waist volume, weight, determination of body mass index, study of laboratory parameters, namely general blood and urine analysis, biochemical blood tests (determination of concentration of uric acid, creatinine, fasting plasma glucose, total cholesterol, triglycerides, high and low density lipoprotein cholesterol, C-reactive peptide, fibrinogen, seromucoids, erythrocyte sedimentation rate, glomerular filtration rate calculation). Instrumental methods of examination included radiography of the joints, ultrasound examination of the kidneys. Results. At dynamic observation during treat-ment, there was a tendency to a decrease in uric acid concentration after 12 months by 38.35% in the first group and by 23% in the second group and after 24 months by 49.12% in the first group and by 36.68% in second group. However, the difference between the indi-cators in both groups was statistically significant (Р>0,2). After 12 and 24 months, a statistically significant de-crease in such inflammatory markers in the main group as C -reactive peptide and seromucoids was noted, at the same time fibrinogen and erythrocyte sedimentation rate tended to decrease, but the difference was not statistically significant. In assessing renal function, a significant decrease was observed in the concentration of creatinine and urea and an increase in glomerular filtration rate in the main group were noted. Lipidogram data were also analyzed - in group 1, the level of low-density lipoprotein cholesterol significantly decreased after 12 months and 24 months, and the level of high-density lipoprotein cholesterol increased, relative to the level of total cholesterol and triglycerides there was a downward trend in these indicators. At the same time, there were no significant differences in group 2. Conclusions. The use of quercetin in the treatment of patients with gout on the background of metabolic syndrome is an effective addition to the standard treatment regimen, which significantly reduces the level of uric acid in the blood, improves kidney func-tion and normalizes the lipid metabolism, helps to reduce the severity of the inflammatory process.