Pascart Tristan, Ramon André, Ottaviani Sébastien, Legrand Julie, Ducoulombier Vincent, Houvenagel Eric, Norberciak Laurène, Richette Pascal, Becce Fabio, Ornetti Paul, Budzik Jean-François
Department of Rheumatology, Lille Catholic Hospitals, University of Lille, F-59160 Lomme, France.
EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, F-59000 Lille, France.
J Clin Med. 2020 May 1;9(5):1295. doi: 10.3390/jcm9051295.
(1) Background: To determine which factors are associated with the volume of monosodium urate (MSU) crystal deposition quantified by dual-energy computed tomography (DECT) in urate-lowering therapy (ULT)-naive gout patients. (2) Methods: In this multicenter cross-sectional study, DECT scans of knees and feet/ankles were prospectively obtained from ULT-naive gout patients. Demographic, clinical (including gout history and comorbidities), and biological data were collected, and their association with DECT MSU crystal volume was analyzed using bivariate and multivariate analyses. A second bivariate analysis was performed by splitting the dataset depending on an arbitrary threshold of DECT MSU volume (1 cm). (3) Results: A total of 91 patients were included. In the bivariate analysis, age ( = 0.03), gout duration ( = 0.003), subcutaneous tophi ( = 0.004), hypertension ( = 0.02), diabetes mellitus ( = 0.05), and chronic heart failure ( = 0.03) were associated with the total DECT volume of MSU crystal deposition. In the multivariate analysis, factors associated with DECT MSU volumes ≥1 cm were gout duration (odds ratio (OR) for each 10-year increase 3.15 (1.60; 7.63)), diabetes mellitus (OR 4.75 (1.58; 15.63)), and chronic heart failure (OR 7.82 (2.29; 31.38)). (4) Conclusion: Specific comorbidities, particularly chronic heart failure and diabetes mellitus, are more strongly associated with increased MSU crystal deposition in knees and feet/ankles than gout duration, regardless of serum urate level.
（1）背景：确定在未接受降尿酸治疗（ULT）的痛风患者中，哪些因素与通过双能计算机断层扫描（DECT）定量的单钠尿酸盐（MSU）晶体沉积量相关。（2）方法：在这项多中心横断面研究中，前瞻性地获取了未接受ULT的痛风患者的膝关节和足/踝关节的DECT扫描图像。收集了人口统计学、临床（包括痛风病史和合并症）及生物学数据，并使用双变量和多变量分析方法分析了它们与DECT MSU晶体体积的关联。根据DECT MSU体积的任意阈值（1 cm）对数据集进行划分，进行了第二次双变量分析。（3）结果：共纳入91例患者。在双变量分析中，年龄（P = 0.03）、痛风病程（P = 0.003）、皮下痛风石（P = 0.004）、高血压（P = 0.02）、糖尿病（P = 0.05）和慢性心力衰竭（P = 0.03）与MSU晶体沉积的总DECT体积相关。在多变量分析中，与DECT MSU体积≥1 cm相关的因素为痛风病程（每增加10年的比值比（OR）为3.15（1.60；7.63））、糖尿病（OR为4.75（1.58；15.63））和慢性心力衰竭（OR为7.82（2.29；31.38））。（4）结论：特定的合并症，尤其是慢性心力衰竭和糖尿病，与膝关节和足/踝关节中MSU晶体沉积增加的关联比痛风病程更强，且与血清尿酸水平无关。
