Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Endocrinology and Metabolism, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2023 Feb 21;14:1077059. doi: 10.3389/fendo.2023.1077059. eCollection 2023.
By studying the changes of serum uric acid (SUA) in acute stage and remission stage of gouty arthritis, we aimed to explore the relationship between the changes of SUA level and free glucocorticoids and inflammatory factors.
A prospective, longitudinal study was conducted on 50 acute gout patients in the dedicated gout clinic of the Affiliated Hospital of Qingdao University. Blood and 24-hour urine samples were collected during the acute phase and two weeks after the initial visit. Patients with acute gouty arthritis were treated primarily with colchicine and nonsteroidal anti-inflammatory drugs.
A total of 32 patients completed the two-week follow-up trial. SUA levels were significantly downregulated during the acute flare than after the flare (464.14 ± 90.97 . 527.36 ± 86.90 μmol/L, < 0.001). The 24-hour fractional excretion of uric acid (24 h FEur) (5.54 ± 2.82% . 4.68 ± 2.83%, < 0.001) and 24-hour urinary uric acid excretion (24 h Uur) (663.08 ± 249.48 μmol/L . 540.87 ± 263.18 μmol/L, = 0.001) increased significantly in patients during the acute phase. The percent change in SUA was associated with those in 24 h FEur and C-reactive protein. Meanwhile, the percent change in 24 h Uur was associated with those in 24-hour urinary free cortisol, percent change in interleukin 1β and interleukin 6.
Decreased SUA level during the acute gout flare was associated with increased excretion of urinary uric acid. Inflammatory factors and bioactive free glucocorticoids may play significant roles in this process.
通过研究痛风性关节炎急性发作期和缓解期血清尿酸（SUA）的变化，探讨 SUA 水平变化与游离糖皮质激素和炎症因子的关系。
对青岛大学附属医院痛风专病门诊 50 例急性痛风患者进行前瞻性、纵向研究。在急性发作期和初诊后 2 周采集患者血液和 24 小时尿液标本。急性痛风性关节炎患者主要采用秋水仙碱和非甾体抗炎药治疗。
共有 32 例患者完成了 2 周随访试验。与痛风发作后相比，SUA 水平在急性发作时明显降低（464.14±90.97μmol/L 比 527.36±86.90μmol/L，<0.001）。24 小时尿酸排泄分数（24 h FEur）（5.54±2.82%比 4.68±2.83%，<0.001）和 24 小时尿尿酸排泄量（24 h Uur）（663.08±249.48μmol/L 比 540.87±263.18μmol/L，=0.001）在急性发作期患者中显著增加。SUA 的变化百分比与 24 h FEur 和 C 反应蛋白的变化百分比相关。同时，24 h Uur 的变化百分比与 24 小时尿游离皮质醇、白细胞介素 1β和白细胞介素 6 的变化百分比相关。
痛风急性发作期 SUA 水平降低与尿尿酸排泄增加有关。炎症因子和生物活性游离糖皮质激素在此过程中可能发挥重要作用。
