Department of Cardio-Thoracic and Respiratory Science, University of Campania "Luigi Vanvitelli", Naples, Italy.
IX Division of General Surgery, Vascular Surgery, and Applied Biotechnology, Naples University Polyclinic, Naples, Italy.
Obes Surg. 2018 May;28(5):1263-1270. doi: 10.1007/s11695-017-2984-z.
Obese patients with preoperative gout often suffer of gouty attacks after bariatric surgery (BS), probably due to the lack of an adequate postoperative diet.
The objectives of the study are to assess whether sleeve gastrectomy (SG) is effective in reducing the frequency of gouty attacks and also whether a postoperative low-purine diet (LPD) may further reduce these attacks as compared to a normal-purine diet (NPD) in a series of patients suffering of gout before SG.
In this retrospective study, we measured and compared total body weight (TBW), body mass index (BMI), uric acid levels (UAL), anti-gout medication (allopurinol) requirements, and frequency in gouty attacks in 40 patients that underwent SG and who received either a LPD (n = 24) or NPD (n = 16). Compliance in following the prescribed diet was assessed in both groups study.
Before surgery, LPD and NPD patients had hyperuricemia and were receiving allopurinol. One year after SG, LPD and NPD groups showed a significant decrease in serum UAL (p < 0.001 and p = 0.00175, respectively). However, serum UAL decreased more significantly with the LPD compared to the NPD (p < 0.001). Furthermore, while NPD group showed a significant decrease in allopurinol requirements (p = 0.00130) and on the frequency in gouty attacks (p < 0.001), LPD group were off allopurinol therapy and had no gouty attacks 12 months after SG. Both groups showed high compliance in following the prescribed diets.
LPD is more effective in reducing the frequency of gouty attacks after SG compared with NPD in patients suffering of gout before surgery.
术前患有痛风的肥胖患者在接受减重手术后（BS）经常会出现痛风发作，这可能是由于术后饮食不当所致。
本研究旨在评估袖状胃切除术（SG）是否能有效降低痛风发作的频率，以及在接受 SG 的痛风患者中，与正常嘌呤饮食（NPD）相比，术后低嘌呤饮食（LPD）是否能进一步降低这些发作。
在这项回顾性研究中，我们测量并比较了 40 例接受 SG 的患者的总体体重（TBW）、体重指数（BMI）、尿酸水平（UAL）、抗痛风药物（别嘌醇）的需求以及痛风发作的频率，这些患者在接受 SG 之前均患有痛风，并分别接受了 LPD（n=24）或 NPD（n=16）。在两组研究中均评估了对规定饮食的依从性。
在手术前，LPD 和 NPD 患者均有高尿酸血症且正在服用别嘌醇。SG 一年后，LPD 和 NPD 组的血清 UAL 均显著降低（p<0.001 和 p=0.00175）。然而，LPD 组的血清 UAL 下降幅度明显大于 NPD 组（p<0.001）。此外，尽管 NPD 组的别嘌醇需求（p=0.00130）和痛风发作频率（p<0.001）显著降低，但 LPD 组在 SG 后 12 个月停用了别嘌醇且无痛风发作。两组患者对规定饮食的依从性均较高。
与术前患有痛风的患者接受 NPD 相比，LPD 在 SG 后更能有效降低痛风发作的频率。
