摘要
目的了解痛风患者身体成分特征及其临床意义.方法纳入2017年8月至2018年12月在中山大学孙逸仙纪念医院风湿免疫科就诊的痛风患者,收集其临床资料.采用生物电阻抗法评估入选痛风患者的身体成分,包括体脂百分比、躯干和四肢的体脂百分比、四肢肌肉指数,并进行多元线性回归分析其相关因素.结果共入选362例痛风患者,男性348例(96.1%),女性14例(3.9%),中位年龄38(30,52)岁,血尿酸(551±133)μmol/L,体脂百分比(25.8±6.4)%,194例(53.6%)患者体脂超标.体脂超标的男性痛风患者较体脂正常者受累关节数[4(2,6)个比2(2,5)个]、血尿酸[(576± 126)μmol/L比(523±134)μmol/L]、合并血脂异常[131例(70.1%)比87例(54.0%)]、代谢综合征[118例(60.8%)比47例(28.0%)]、脂肪肝[113例(58.2%)比59例(35.1%)]、高血压[83例(44.4%)比41例(25.5%)]的比例均明显升高(P值均<0.05).相关性分析显示,体脂百分比、躯干体脂百分比、四肢体脂百分比与受累关节数、血尿酸、代谢综合征、脂肪肝、高血压呈正相关(r=0.154~0.435,P值均<0.05).多因素线性回归分析显示,体脂百分比(β=4.29, P=0.020)、体脂超标(β=41.46,P=0.020 ).躯干体脂百分比(β=9.11,P=0.007)与血尿酸相关.结论痛风患者体脂超标常见,男性痛风患者脂肪多分布于躯干,且躯干脂肪与血尿酸水平呈正相关.临床评估痛风患者肥胖时,应同时行身体成分分析,评估脂肪总量及分布.
Objective To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF%≥25% for male and≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1%(348/362) were male. Mean sUA was(551±133)μmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576 ± 126)μmol/L vs.(523 ± 134)μmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF%(β=4.29, P=0.020) and trunk BF%(β=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.
作者
邓超
李谦华
杨莉娟
梁锦坚
莫颖倩
林建子
郑东辉
戴冽
Deng Chao;Li Qianhua;Yang Lijuan;Liang Jinjian;Mo Yingqian;Lin Jianzi;Zheng Donghui;Dai Lie(Department of Rheumatology and Immunology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2019年第10期751-757,共7页
Chinese Journal of Internal Medicine
基金
广东省自然科学基金(2014A030310086).
