Alterations in lipidome profiles distinguish early-onset hyperuricemia, gout, and the effect of urate-lowering treatment

Background Currently, it is not possible to predict whether patients with hyperuricemia (HUA) will develop gout and how this progression may be affected by urate-lowering treatment (ULT). Our study aimed to evaluate differences in plasma lipidome between patients with asymptomatic HUA detected <= 40 years (HUA <= 40) and > 40 years, gout patients with disease onset <= 40 years (Gout <= 40) and > 40 years, and normouricemic healthy controls (HC). Methods Plasma samples were collected from 94 asymptomatic HUA (77% HUA <= 40) subjects, 196 gout patients (59% Gout <= 40), and 53 HC. A comprehensive targeted lipidomic analysis was performed to semi-quantify 608 lipids in plasma. Univariate and multivariate statistics and advanced visualizations were applied. Results Both HUA and gout patients showed alterations in lipid profiles with the most significant upregulation of phosphatidylethanolamines and downregulation of lysophosphatidylcholine plasmalogens/plasmanyls. More profound changes were observed in HUA <= 40 and Gout <= 40 without ULT. Multivariate statistics differentiated HUA <= 40 and Gout <= 40 groups from HC with an overall accuracy of > 95%. Conclusion Alterations in the lipidome of HUA and Gout patients show a significant impact on lipid metabolism. The most significant glycerophospholipid dysregulation was found in HUA <= 40 and Gout <= 40 patients, together with a correction of this imbalance with ULT.