Aim: To study the differences in cardiovascular risk between type 2 diabetic and non-diabetic patients with asymptomatic hyperuricemia and gout using the Framingham Risk Score (FRS) and complex multimodal ultrasonography. Patients and methods: A total of 201 patients participated, divided into two groups: 1/ patients with asymptomatic hyperuricemia (n = 52), and 2/ patients with gout (n = 149). FRS was determined as well as ultrasound parameters, independent predictors of cardiovascular risk:

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... ft atrial size (LA), intima-media thickness (IMT) and common carotid artery resistive index (CCARI). Results: The patients in the two groups were age-matched and conventional cardiovascular risk factors were equally distributed. In the asymptomatic hyperuricemia group, 12 patients (23.1%) had diabetes. In this group, there was no difference in FRS between diabetic and non-diabetic individuals. However, diabetic patients had larger LA, thicker intima-media and higher CCARI. In the gout group 18 subjects (12%) had diabetes, but the FRS, LA, IMT and CCARI values were similar among diabetic and non-diabetic patients. Furthermore, when gout subjects were subdivided according to the presence of tophi, we found that the subgroup having gouty tophi and diabetes had larger LA (p = 0.014) compared to those with gouty tophi without diabetes. Conclusion: In diabetic patients with asymptomatic hyperuricemia and gouty tophi, a more complex approach for estimation of cardiovascular risk is needed. Our work suggests that diabetes and tophi might potentiate their action on the cardiovascular system.