Holland R, McGill N W
Rheumatology Department, Westmead Hospital, Sydney, NSW, 2050, Australia.
Intern Med J. 2015 Feb;45(2):189-94. doi: 10.1111/imj.12661.
BACKGROUND/AIM: This study aims to investigate the influence of dietary education in patients with gout on a stable dose of urate-lowering therapy (ULT).
Males and females aged >18 years with a history of gout, receiving an appropriate and stable dose of ULT, were recruited from two tertiary hospitals and randomised into two groups. The control group received basic advice regarding the importance of compliance with therapy and the benefit of weight loss. The intervention group received comprehensive dietary advice based on the British Society of Rheumatology Guidelines. Both groups received education at baseline and 3 months. Serum urate was measured at baseline, 3 months and 6 months, and a questionnaire was completed at baseline and at 6 months. The primary outcome of the study was to compare the change in serum urate between groups.
Thirty patients were recruited into the study. There was no difference in serum urate between the control and intervention group at 6 months (0.29 mmol/L vs 0.29 mmol/L at baseline and 0.27 mmol/L vs 0.30 mmol/L at 6 months). The intervention group showed a statistically significant improvement in knowledge (8/13 in control group at baseline to 9/13 at 6 months vs 8/13 in intervention group at baseline to 12/13 at 6 months, P < 0.05) and self-reported dietary modification (1 in control vs 7 in intervention P < 0.05) at 6 months.
This randomised controlled trial shows that in patients on ULT, providing education on diet does not lead to any clinically significant difference in serum urate at 6 months.
背景/目的：本研究旨在调查痛风患者饮食教育对稳定剂量降尿酸治疗（ULT）的影响。
从两家三级医院招募年龄>18岁、有痛风病史且接受适当稳定剂量ULT的男性和女性，随机分为两组。对照组接受关于坚持治疗的重要性和减肥益处的基本建议。干预组接受基于英国风湿病学会指南的全面饮食建议。两组在基线和3个月时接受教育。在基线、3个月和6个月时测量血清尿酸，并在基线和6个月时完成一份问卷。该研究的主要结果是比较两组之间血清尿酸的变化。
30名患者被纳入研究。对照组和干预组在6个月时的血清尿酸无差异（基线时分别为0.29 mmol/L和0.29 mmol/L，6个月时分别为0.27 mmol/L和0.30 mmol/L）。干预组在6个月时的知识水平（对照组基线时13人中8人，6个月时9人；干预组基线时13人中8人，6个月时12人，P<0.05）和自我报告的饮食改变（对照组1人，干预组7人，P<0.05）有统计学显著改善。
这项随机对照试验表明，对于接受ULT治疗的患者，提供饮食教育在6个月时不会导致血清尿酸出现任何具有临床意义的差异。
