苯溴马隆对痛风患者体脂的影响  

Effect of benzbromarone on body fat in patients with gout

作　　者：李如一[1] 贺玉伟 刘振[1,2] 崔凌凌 薛晓梅[1] 赵婷 李鑫德 李长贵[1,2,3] Li Ruyi;He Yuwei;Liu Zhen;Cui Lingling;Xue Xiaomei;Zhao Ting;Li Xinde;Li Changgui(Department of Endocrinology and Metabolism,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Shandong Provincial Key Laboratory of Metabolic Diseases,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Institute of Metabolic Diseases,Qingdao University,Qingdao 266003,China;Department of Nutrition,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 [2]山东省代谢性疾病重点实验室,青岛266003 [3]青岛大学代谢病研究院,266003 [4]青岛大学附属医院营养科,266003

出　　处：《中华内分泌代谢杂志》2020年第5期410-415,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金重点国际合作项目(81520108007);科技部国家重点研发计划(2016YFC0903400);山东省重点研发计划(2018CXGC1207)。

摘　　要：目的探讨降尿酸治疗对痛风患者体脂和内脏脂肪面积的影响及相关危险因素。方法招募2018年9月至2019年9月在青岛大学附属医院痛风专病门诊就诊且符合入组条件的痛风患者140例,经2周洗脱,给予苯溴马隆降尿酸治疗,连续12周,检测降尿酸治疗前后血生化、体脂肪(BF)、体脂百分比(BFP)和内脏脂肪面积(VFA),观察检测指标的前后差异及影响BF、BFP及VFA变化的危险因素。结果降尿酸治疗后患者舒张压(DBP)、丙氨酸转氨酶(ALT)、血尿酸(sUA)、BF、BFP和VFA均显著降低(P<0.05)。多元逐步线性回归分析结果显示,sUA、肌酐(Cr)和肾小球滤过率(eGFR)是影响体脂和内脏脂肪面积改善的独立危险因素(P<0.05)。降尿酸治疗前、后痛风患者血尿酸水平越低,体脂及内脏脂肪面积改善越显著(P<0.05)。结论痛风合并高尿酸血症与内脏型肥胖密切相关,降尿酸治疗不仅显著改善痛风患者血尿酸水平,还能在一定程度上改善患者体脂和内脏脂肪面积。Objective To investigate the effect of urate-lowering therapy(ULT)on body fat and visceral fat areas in patients with gout and to analyze the related risk factors.Methods A total of 140 patients with gout eligible for enrollment were recruited from the gout clinic in the Affiliated Hospital of Qingdao University from Sept.2018 to Sept.2019.After 2 weeks of washout,all patients were treated with benzbromarone for consecutive 12 weeks.The data of blood biochemical,body fat(BF),body fat percentage(BFP)and visceral fat area(VFA)were collected,and the differences before and after ULT as well as the risk factors affecting the changes of BF,BFP,and VFA were analyzed.Results The diastolic blood pressure(DBP),alanine aminotransferase(ALT),serum uric acid(sUA),BF,BFP,and VFA were significantly decreased after ULT(P<0.05).The results of multivariate stepwise linear regression analysis showed that sUA,creatinine(Cr)and glomerular filtration rate(eGFR)were independent risk factors affecting the improvement of BF and VFA(P<0.05).Lower serum uric acid levels in patients with gout before and after ULT indicated better improvement effect of body fat and visceral fat areas(P<0.05).Conclusion Gout combined with hyperuricemia is closely related to visceral obesity.In addition to lowering the serum uric acid level,ULT could also benefit the body fat and visceral fat area in patients with gout to some extent.

关 键 词：痛风 血尿酸 体脂 内脏脂肪面积 

分 类 号：R589[医药卫生—内分泌]