Liu Chan Jung, Wu Jin Shang, Huang Ho Shang
Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
J Clin Med. 2019 Sep 25;8(10):1536. doi: 10.3390/jcm8101536.
Uric acid urolithiasis constitutes approximately 7-10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01-0.61, = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01-0.61, = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.
尿酸结石约占所有泌尿系统结石的7%-10%。既往研究表明,痛风患者并非均患有尿酸结石。相反,尿酸结石患者患痛风的风险仍存在争议。本研究旨在调查糖尿病(DM)患者和非糖尿病尿酸结石患者患痛风的相关风险是否存在差异。因此,我们检查了所有基线化学指标,以确定与尿酸结石患者发生痛风相关的任何危险因素或保护因素。选取了一家医疗中心的99例结石标本中含有尿酸成分的患者,对其2010年1月至2016年12月期间的病历进行回顾性分析。所有患者分为痛风组和非痛风组。本研究中24例患者确诊为痛风(24.2%)。非痛风组的糖尿病比例(34.7%)显著高于痛风组(4.3%,P<0.05)。痛风患者的肾功能下降,血清甘油三酯升高。合并DM的尿酸结石患者患痛风的风险较低(调整后的优势比:0.08;95%置信区间(CI)=0.01-0.61,P=0.015)。在89例以尿酸结石为主(尿酸成分>50%)的患者中,糖尿病患者患痛风的风险仍低于非糖尿病患者(调整后的优势比:0.08;95%置信区间(CI)=0.01-0.61,P=0.015)。这些发现表明,糖尿病尿酸结石患者患痛风的风险降低。我们的结果提示,尿酸结石患者在服用尿酸控制药物之前应进行全面的糖尿病评估。