住院痛风患者合并肝肾功能受损的临床特点及相关危险因素比较  

Clinical characteristics and related risk factors of impaired liver and renal function in hospitalized patients with gout

作　　者：陈宁宁 程晓宇[1] 刘甜[1] 马利丹[1] 陈钊颖 齐涵 邢宝迪 孙瑞霞[1] Chen Ningning;Cheng Xiaoyu;Liu Tian;Ma Lidan;Chen Zhaoying;Qi Han;Xing Baodi;Sun Ruixia(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,青岛266003

出　　处：《中华内分泌代谢杂志》2022年第12期1029-1033,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(31900413)

摘　　要：目的分析住院痛风并肝肾功能受损患者临床特点及危险因素。方法收集2019年1月至2020年12月青岛大学附属医院内分泌代谢科住院的痛风患者494例的临床资料,据肝肾功能分为对照组(Con组)、肝功能受损组(ILF组)、肾功能受损组(IRF组)及肝肾功能均受损组(ILRF组),多因素logistic回归分析痛风患者肝肾功能受损的危险因素。结果ILF组年龄、痛风病程小于Con组(均P<0.05),体重指数、腰围、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血尿酸、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、三酰甘油、C反应蛋白及血脂异常、肥胖、脂肪肝、尿酸盐结晶(MSU)沉积比例高于Con组(均P<0.05);IRF组年龄、血尿酸、血肌酐、C反应蛋白及高血压、MSU沉积比例高于Con组(均P<0.05),脂肪肝比例低于Con组(P<0.05)。IRF组年龄、痛风病程大于ILF组(均P<0.05),体重指数、腰围、HOMA-IR、LDL-C、总胆固醇、三酰甘油及肥胖、脂肪肝比例低于IRF组(均P<0.05),合并高血压、2型糖尿病比例高于IRF组(均P<0.05)。多因素logistic回归分析显示,年龄(OR=0.941,95%CI 0.906~0.977,P<0.001)、血尿酸(OR=1.002,95%CI 1.000~1.005,P=0.043)、HOMA-IR(OR=1.147,95%CI 1.024~1.285,P=0.018)、MSU沉积(OR=1.959,95%CI 1.154~3.326,P=0.013)是肝功受损的独立危险因素,年龄(OR=1.104,95%CI 1.048~1.162,P<0.001)、血尿酸(OR=1.007,95%CI 1.004~1.010,P<0.001)、MSU沉积(OR=2.393,95%CI 1.191~4.805,P=0.014)是肾功能受损的独立危险因素。结论血尿酸和MSU沉积是痛风患者发生肝肾功能受损的共同危险因素。年轻、伴胰岛素抵抗者发生肝功能受损的风险大,高龄伴高血压、糖尿病者容易发生肾功能受损。Objective To analyze the clinical characteristics and risk factors of impaired liver and renal function in hospitalized patients with gout.Methods A total of 494 hospitalized patients with confirmed gout were selected and divided into four groups according to liver and renal function,control(Con),impaired liver function(ILF),impaired renal function(IRF),and both function impaired(ILRF)group.Multivariate logistic regression was used to analyze the risk factors related with impaired liver and renal function.Results Compared to Con group,ILF group were younger with shorter gout duration,higher body mass index,waist circumference,homeostasis model assessment for insulin resistance(HOMA-IR),serum uric acid,low density lipoprotein-cholesterol(LDL-C),total cholesterol,triglycerides,C reactive protein,higher prevalence of dyslipidemia,obesity,fatty liver,and monosodium urate crystal(MSU)deposition(all P<0.05).IRF group were older and with higher serum uric acid,serum creatinine,C reactive protein,and hypertension,MSU deposition prevalence,with lower prevalence of fatty liver(all P<0.05).Compared to ILF group,IRF group were older,with longer gout duration,lower level of body mass index,waist circumference,HOMA-IR,LDL-C,total cholesterol,triglycerides,lower prevalence of obesity,fatty liver,and higher prevalence of hypertension and type 2 diabetes(all P<0.05).The univariate logistic regression analysis showed that age(OR=0.941,95%CI 0.906-0.977,P<0.001),serum uric acid(OR=1.002,95%CI 1.000-1.005,P=0.043),HOMA-IR(OR=1.147,95%CI 1.024-1.285,P=0.018),and MSU deposition(OR=1.959,95%CI 1.154-3.326,P=0.013)were the independent risk factors of impaired liver function,while the independent risk factors of impaired renal function were age(OR=1.104,95%CI 1.048-1.162,P<0.001),serum uric acid(OR=1.007,95%CI 1.004-1.010,P<0.001),and MSU deposition(OR=2.393,95%CI 1.191-4.805,P=0.014).Conclusions Serum uric acid and MSU deposition are the common independent risk factors for impaired liver and renal function in patients with gout.Younger

关 键 词：痛风 肝功能受损 肾功能受损 危险因素 

分 类 号：R589.7[医药卫生—内分泌]