Université de Lille, EA440, and Hôpital Saint-Philibert, F-59160, Lomme, France.
Université Paris Diderot, Sorbonne Paris Cité, F-75205, AP-HP, Hôpital Lariboisière, Viggo Petersen, F-75010, and INSERM, UMR 1132, Paris, France.
Arthritis Care Res (Hoboken). 2019 Jul;71(7):986-992. doi: 10.1002/acr.23706. Epub 2019 Jun 12.
Little is known of the clinical features and comorbidity profile of patients presenting with early-onset gout (EOG), although international guidelines recommend rapid treatment after diagnosis. The objective of this study was to assess specific characteristics and comorbidities of patients with gout who had an early onset.
Patients from a cross-sectional French national cohort who experienced their first gout flare before age 40 years were included in the EOG group and compared to patients with an onset after age 40 years, the common gout group.
A total of 120 patients were included in the EOG group (mean ± SD age 49.5 ± 11.9 years) and 865 patients in the common gout group (mean ± SD age 64.4 ± 10.1 years). Patients with EOG more often presented with a history of polyarticular flares (P < 0.01), but had similar frequency of flares (P = 0.16), gout arthropathy (P = 0.79), and tophi (P = 0.53). Prevalence of each item comprising metabolic syndrome did not differ between groups. In patients with EOG, all cardiovascular comorbidities were diagnosed after gout onset. Greater age, low high-density lipoprotein, and excessive alcohol intake were associated in multivariate analysis with the common gout group, while a familial history of gout, longer duration of urate-lowering treatment, higher serum uric acid levels, and metabolic syndrome were associated with the EOG group.
Patients with EOG developed slightly more severe joint involvement and earlier metabolic disorders than patients with common gout.
尽管国际指南建议在确诊后迅速进行治疗，但对于早发性痛风（EOG）患者的临床特征和合并症谱知之甚少。本研究旨在评估早发性痛风患者的特定特征和合并症。
本研究纳入了来自法国一项横断面全国队列研究的患者，这些患者在 40 岁之前首次出现痛风发作，归入 EOG 组，并与 40 岁后发病的普通痛风组患者进行比较。
共纳入 120 例 EOG 患者（平均年龄 ± 标准差为 49.5 ± 11.9 岁）和 865 例普通痛风组患者（平均年龄 ± 标准差为 64.4 ± 10.1 岁）。EOG 患者更常出现多关节发作史（P < 0.01），但发作频率相似（P = 0.16）、痛风关节炎（P = 0.79）和痛风石（P = 0.53）。两组间代谢综合征各项目的患病率无差异。在 EOG 患者中，所有心血管合并症均在痛风发作后确诊。在多变量分析中，年龄较大、低高密度脂蛋白和过量饮酒与普通痛风组相关，而痛风家族史、降尿酸治疗时间更长、血尿酸水平更高和代谢综合征与 EOG 组相关。
与普通痛风患者相比，EOG 患者的关节受累程度略严重，且更早出现代谢紊乱。
