Background: Gout is a chronic inflammatory disorder stemming from metabolic dysfunction, characterized by the accumulation of monosodium urate crystals in joints and soft tissues due to prolonged hyperuricemia. Clinically, it often manifests with abrupt onset of intense joint pain, erythema, swelling, and tenderness, particularly in the small joints of the lower extremities such as the first metatarsophalangeal joint, ankles, and knees. In its chronic form, gout can lead to the development of tophi—firm nodular deposits of urate crystals— resulting in joint deformities, limited mobility, and systemic complications affecting the renal and cardiovascular systems. This case report describes the integrative management of a 68-year-old male patient with a long-standing history of chronic tophaceous gout, presenting with acute exacerbation involving multiple joints and extensive tophaceous deposits. The patient underwent a course of traditional Mongolian medical treatment, incorporating bloodletting therapy (hanuur), soaking therapy (devteeleg zasal), and phytotherapeutic remedies. Conclusion The treatment yielded notable clinical improvements: cupping therapy facilitated the reduction of joint inflammation and edema, alleviated pain, and enhanced peripheral circulation during the acute phase. Soaking therapy using medicated decoctions was effective in softening and reducing the size of tophi, promoting wound drying, restoring joint mobility, and improving overall functional capacity. The patient reported a marked enhancement in quality of life following the integrative treatment course. This case highlights the potential of traditional Mongolian medical interventions as adjunctive or alternative therapeutic strategies for managing severe gout, particularly in cases refractory to conventional pharmacological treatment. Further clinical research and controlled studies are warranted to validate these findings and to explore the broader application of traditional therapies in gout management.

Background: Obesity, especially central obesity, is a risk factor for non-communicable chronic diseases such as dyslipidemia, type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and metabolic syndrome (MetS). Aim: Study the association between the subcutaneous fat area (SFA) and visceral fat area (VFA) with lipid metabolism parameters in adults with MetS. Materials and Methods: Data from 1511 participants who visited the ‘NURA Mongolia’ Ai Health screening center between September 2023 and February 2024, including general information, DEXA (Dual X-ray Absorptiometry), and biochemical analysis results, were used. Metabolic syndrome (MeS) was assessed based on the harmonizing criteria 2009 (≥3 criteria). VFA and SFA were categorized into four groups using quartiles (Q1-Q4). Statistical analysis was performed using SPSS v26, including T-tests, multiple logistic regression (OR, 95% CI), and ROC (AUC) analysis. Results: The average age of the participants was 30.5±3.9 years, with a BMI of 25.1 kg/m², and 49.5% were male. The group with MetS (n=531) had significantly higher levels of VFA and SFA compared to the group that rated their health as relatively healthy and had no clinical diagnosis (n=979) (control group) (p<0.0001), with males showing higher VFA and females showing higher SFA (p<0.0001). The Q4 group for VFA had a significant association with MetS in males (4.611, 95% CI=2.394–9.591) and females (2.253, 95% CI=1.097-3.912) (p<0.001). Logistic regression analysis showed that increased VFA was more strongly associated with MetS in males (β=0.325, p<0.0001) and females (β=0.338, p<0.003) than BMI. The AUC for predicting MetS was 0.790 (95% CI=0.750-0.831) for VFA and 0.401 (95% CI=0.351-0.451) for SFA, with all results being statistically significant (p<0.001). VFA had a higher predictive value compared to other markers. Conclusion In healthy men with metabolic syndrome, VFA is more prominently defined, while SFA is higher in healthy women. Since VFA is a better predictor of metabolic syndrome than SFA, it increases the risk of diseases such as cardiovascular diseases and type 2 diabetes in men, whereas SFA in women serves as a protective factor.