Abhishek Abhishek, Valdes Ana M, Jenkins Wendy, Zhang Weiya, Doherty Michael
Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, United Kingdom.
PLoS One. 2017 Oct 12;12(10):e0186096. doi: 10.1371/journal.pone.0186096. eCollection 2017.
To determine the proportion of people with gout who self-report triggers of acute attacks; identify the commonly reported triggers, and examine the disease and demographic features associated with self-reporting any trigger(s) of acute attacks of gout.
Individuals with gout were asked to fill a questionnaire enquiring about triggers that precipitated their acute gout attacks. Binary logistic regression was used to compute odds ratio (OR) and 95% confidence intervals (CI) to examine the association between having ≥1 self-reported trigger of acute gout and disease and demographic risk factors and to adjust for covariates. All statistical analyses were performed using STATA.
550 participants returned completed questionnaires. 206 (37.5%) reported at least one trigger of acute attacks, and less than 5% reported >2 triggers. Only 28.73% participants reported that their most recent gout attack was triggered by dietary or lifestyle risk factors. The most frequently self-reported triggers were alcohol intake (14.18%), red-meat or sea-food consumption (6%), dehydration (4.91%), injury or excess activity (4.91%), and excessively warm or cold weather (4.36% and 5.45%). Patients who had onset of gout before the age of 50 years were significantly more likely to identify a trigger for precipitating their acute gout attacks (aOR (95%CI) 1.73 (1.12-2.68) after adjusting for covariates.
Most people with gout do not identify any triggers for acute attacks, and identifiable triggers are more common in those with young onset gout. Less than 20% people self-reported acute gout attacks from conventionally accepted triggers of gout e.g. alcohol, red-meat intake, while c.5% reported novel triggers such as dehydration, injury or physical activity, and weather extremes.
确定自我报告急性发作诱因的痛风患者比例；识别常见的报告诱因，并研究与自我报告痛风急性发作任何诱因相关的疾病和人口统计学特征。
要求痛风患者填写一份问卷，询问引发其急性痛风发作的诱因。采用二元逻辑回归计算比值比（OR）和95%置信区间（CI），以检验自我报告≥1次急性痛风发作诱因与疾病及人口统计学风险因素之间的关联，并对协变量进行调整。所有统计分析均使用STATA进行。
550名参与者返回了完整的问卷。206人（37.5%）报告了至少一种急性发作诱因，不到5%的人报告了超过2种诱因。只有28.73%的参与者报告其最近一次痛风发作是由饮食或生活方式风险因素引发的。最常自我报告的诱因是饮酒（14.18%）、食用红肉或海鲜（6%）、脱水（4.91%）、受伤或活动过度（4.91%）以及天气过暖或过冷（4.36%和5.45%）。痛风发病年龄在50岁之前的患者在调整协变量后，更有可能识别出引发其急性痛风发作的诱因（调整后比值比（95%CI）为1.73（1.12 - 2.68））。
大多数痛风患者无法识别急性发作的任何诱因，可识别的诱因在年轻发病的痛风患者中更为常见。不到20%的人自我报告急性痛风发作是由传统上公认的痛风诱因引起的，如饮酒、摄入红肉，而约5%的人报告了新的诱因，如脱水、受伤或体力活动以及极端天气。
