男性痛风患者肝功能异常的相关危险因素分析  

Analysis of risk factors for susceptibility of abnormal liver function in male patients with gout

作　　者：刘甜[1] 孙瑞霞[1] 程晓宇[1] 马利丹[1] 辛颖[1] 贾兆通[1] 陈颖[1] 王青[1] 李长贵[1] Liu Tian;Sun Ruixia;Cheng Xiaoyu;Ma Lidan;Xin Ying;Jia Zhaotong;Chen Ying;Wang Qing;Li Changgui(Department of Endocrinology and Metabolic Diseases,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌与代谢性疾病科,266003

出　　处：《中华内分泌代谢杂志》2020年第2期100-105,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81770869);国家自然科学基金青年项目(81600601)。

摘　　要：目的探讨男性痛风患者合并肝功能异常的危险因素,为其早期防治提供临床依据。方法选取2011年4月至2018年9月青岛大学附属医院痛风医学中心门诊及住院男性痛风缓解期患者5044例,根据肝功能情况分为肝功能异常组(1351例)和肝功能正常组(3693例),分别采集临床资料,测定生化指标,将血尿酸分为四分位,分析其与肝功能异常的关系。结果肝功能异常组与正常组患者饮酒史、痛风家族史、合并血脂异常、脂肪肝和冠心病的比例存在明显的统计学差异(P<0.05或P<0.01);肝功能异常组与正常组患者初诊年龄、痛风病程、体重指数(BMI)、腰围(WC)、舒张压(DBP)、胆固醇(TC)、三酰甘油(TG)、尿酸(UA)、肌酐清除率(Ccr)差异有统计学意义(均P<0.01);两组的吸烟史、是否规律运动、合并高血压、糖尿病的比例以及收缩压(SBP)、血糖(GLU)的差异均无统计学意义(均P>0.05)。Logistic回归分析显示BMI、WC、TG、TC及UA是否合并脂肪肝是痛风患者肝功能异常的危险因素。进一步将尿酸按四分位分组,发现丙氨酸转氨酶(ALT)及肝功能异常的比例均随尿酸水平升高而逐渐升高;在校正WC、TG、TC及脂肪肝后,ALT及肝功能异常比例明显下降,但仍呈上升趋势。结论WC、BMI、TG、TC、UA、脂肪肝是痛风患者肝功能异常的危险因素,UA与ALT升高独立相关。Objective To investigate the risk factors for susceptibility of abnormal liver function in patients with gout.Methods A total of 5044 cases of male gout patients in remission were selected and divided into normal liver function group with 3693 patients and abnormal liver function group with 1351 patients.The clinical information was collected and relevant biochemical indices were detected.Serum uric acid(SUA)was divided into quartiles,and its associations with elevated ALT were evaluated.Results There were significant differences in the history of drinking,family history,combining with hyperlipidemia,fatty liver,and coronary heart disease between the abnormal liver function group and normal function group(P<0.05 or P<0.01).There were significant statistical differences in age,disease duration,body mass index,waist circumference,diastolic blood pressure,serum cholesterol and triglyceride,uric acid,and creatinine clearance rate between 2 groups(P<0.01),while without significant difference in history of smoking,regular exercise,combining hypertension and diabetes,the means of systolic blood pressure,and fasting blood glucose(all P>0.05).Further logistic regression analysis indicated that body mass,waist circumference,combining fatty liver,higher SUA level,higher cholesterol and triglyceride were risk factors of the early onset of abnormal liver function.ALT and the proportion of abnormal liver function were increased with the increase of UA.After adjustment for BMI,TG,TC and fatty liver,the ALT level and the proportion of abnormal liver function decreased significantly while still showed an upward trend.Conclusion Patients with obesity,high level of uric acid,high blood lipids and fatty liver were more likely to develop abnormal liver function,SUA was independently associated with elevated ALT.

关 键 词：痛风 肝功能异常 危险因素 

分 类 号：R589.7[医药卫生—内分泌]