Division of Rheumatology, University of Minnesota Medical School, Minneapolis, MN, USA.
J Clin Rheumatol. 2010 Sep;16(6):262-6. doi: 10.1097/RHU.0b013e3181eeb487.
To compare characteristics of gout in Hmong patients versus whites, and examine if Hmong ethnicity is associated with risk of tophaceous gout.
A retrospective chart review of Hmong and White patients with gout in a large health care system (Health Partners) in St. Paul, Minnesota, from January 2001 to March 2008, to compare clinical characteristics and risk factors for gout. Multivariable-adjusted hierarchical logistic regressions examined the association of Hmong ethnicity with risk of tophaceous gout, adjusting for age, sex, hypertension, diuretic use, and kidney function.
The analytic dataset consisted of 89 Hmong patients and 84 White controls, all of whom had ethnicity confirmed, an International Classification of Diseases, ninth revision code for gout and had at least 2 physician-documented diagnoses of gout. The Hmong group was younger (58.3 vs. 66.3 years, P = 0.04), had an earlier onset of symptoms (37.4 vs. 55.0 years, P < 0.001) and higher mean serum uric acid levels during follow-up (9.1 vs. 7.6 mg/dL, P < or = 0.001). Hmong had higher rates of tophaceous gout (31.5% vs. 10.7%, P = 0.001), including hand tophi (21.3% vs. 3.6%, P < 0.001). In multivariable analyses that adjusted for age, sex, hypertension, diuretic, use, and kidney function, Hmong ethnicity was significantly associated with risk of tophaceous gout, with odds ratio 4.3 (95% confidence interval: 1.5, 12.2).
Hmong patients have an earlier onset of gout symptoms. Hmong race is an independent risk factor for tophaceous gout. Future studies need to examine whether genetic or other comorbid factors predict this higher risk of more severe gout in Hmong.
比较苗族患者与白人患者痛风特征，探讨苗族种族是否与痛风石形成风险相关。
采用回顾性图表分析方法，对明尼苏达州圣保罗市大型医疗保健系统（Health Partners）2001 年 1 月至 2008 年 3 月间苗族和白人痛风患者的临床特征和痛风风险因素进行比较。多变量调整分层逻辑回归分析用于检验苗族种族与痛风石形成风险的关联，调整因素包括年龄、性别、高血压、利尿剂使用和肾功能。
分析数据集包括 89 例苗族患者和 84 例白人对照组，所有患者均经确认种族，国际疾病分类第 9 版痛风编码，并至少有 2 次医生记录的痛风诊断。苗族组年龄较轻（58.3 岁比 66.3 岁，P=0.04），症状发作更早（37.4 岁比 55.0 岁，P<0.001），随访期间平均血清尿酸水平更高（9.1 毫克/分升比 7.6 毫克/分升，P<或=0.001）。苗族组痛风石形成率较高（31.5%比 10.7%，P=0.001），包括手部痛风石（21.3%比 3.6%，P<0.001）。多变量分析调整年龄、性别、高血压、利尿剂使用、肾功能后，苗族种族与痛风石形成风险显著相关，比值比为 4.3（95%置信区间：1.5，12.2）。
苗族患者痛风症状发作较早。苗族种族是痛风石形成的独立危险因素。未来的研究需要探讨遗传或其他合并症因素是否可以预测苗族患者更严重痛风的更高风险。
