Romero-Talamás Héctor, Daigle Christopher R, Aminian Ali, Corcelles Ricard, Brethauer Stacy A, Schauer Philip R
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Surg Obes Relat Dis. 2014 Nov-Dec;10(6):1161-5. doi: 10.1016/j.soard.2014.02.025. Epub 2014 Feb 28.
Obesity is a risk factor for the development of gout. An increased incidence of early gouty attacks after bariatric surgery has been reported, but the data is sparse. The effect of weight loss surgery on the behavior of gout beyond the immediate postoperative phase remains unclear. The objective of this study was to evaluate the pre- and postoperative frequency and features of gouty attacks in bariatric surgery patients.
Charts were reviewed to identify patients who had gout before bariatric surgery. Demographic and gout-related parameters were recorded. The comparison group consisted of obese individuals with gout who underwent nonbariatric upper abdominal procedures.
Ninety-nine morbidly obese patients who underwent bariatric surgery had gout. The comparison group consisted of 56 patients. The incidence of early gouty attack in the first month after surgery was significantly higher in the bariatric group than the nonbariatric group (17.5% versus 1.8%, P = .003). In the bariatric group, 23.8% of patients had at least one gouty attack during the 12-month period before surgery, which dropped to 8.0% during postoperative months 1-13 (P = .005). There was no significant difference in the number of gouty attacks in the comparison group before and after surgery (18.2% versus 11.1%, P = .33). There was a significant reduction in uric acid levels 13-months after bariatric surgery compared with baseline values (9.1±2.0 versus 5.6±2.5 mg/dL, P = .007).
The frequency of early postoperative gout attacks after bariatric surgery is significantly higher than that of patients undergoing other procedures. However, the incidence decreases significantly after the first postoperative month up to 1 year.
肥胖是痛风发病的一个危险因素。有报道称减肥手术后早期痛风发作的发生率有所增加，但相关数据较少。减肥手术对痛风发作的影响在术后即刻阶段之后仍不清楚。本研究的目的是评估减肥手术患者术前和术后痛风发作的频率及特征。
回顾病历以确定减肥手术前患有痛风的患者。记录人口统计学和痛风相关参数。对照组由接受非减肥上腹部手术的痛风肥胖个体组成。
99例接受减肥手术的病态肥胖患者患有痛风。对照组有56例患者。减肥组术后第一个月早期痛风发作的发生率显著高于非减肥组（17.5%对1.8%，P = 0.003）。在减肥组中，23.8%的患者在手术前12个月期间至少有一次痛风发作，在术后1至13个月期间降至8.0%（P = 0.005）。对照组手术前后痛风发作次数无显著差异（18.2%对11.1%，P = 0.33）。与基线值相比，减肥手术后13个月尿酸水平显著降低（9.1±2.0对5.6±2.5mg/dL，P = 0.007）。
减肥手术后早期痛风发作的频率显著高于接受其他手术的患者。然而，术后第一个月后至1年发病率显著下降。
