Jiao S, Kameda K, Matsuzawa Y, Tarui S
Second Department of Internal Medicine, Osaka University Medical School, Osaka, Japan.
Ann Rheum Dis. 1986 Apr;45(4):308-13. doi: 10.1136/ard.45.4.308.
Serum lipoprotein profiles were investigated in 108 male patients with primary gout before treatment to elucidate the prevalence of each individual phenotype of coexisting hyperlipoproteinaemia and pathogenic factors responsible for it. The mean serum triglyceride (TG) and total cholesterol (TC) levels in the patients with gout were 2.10 +/- 0.14 mmol/l and 5.26 +/- 0.10 mmol/l (mean +/- SEM) respectively, which were significantly higher (p less than 0.01 and p less than 0.05 respectively) than the levels in age matched controls without gout (1.30 +/- 0.07 mmol/l and 4.77 +/- 0.08 mmol/l respectively). Serum high density lipoprotein cholesterol (HDL-C) values were slightly decreased in patients with gout compared with controls (1.24 +/- 0.08 mmol/l v 1.40 +/- 0.03 mmol/l, p less than 0.05). Hyperlipoproteinaemia was seen in 61 patients (56%), of whom patients with type IIa, IIb, and IV hyperlipoproteinaemia formed 13, 15, and 69% respectively. Thus the prevalence of type IV hyperlipoproteinaemia was high in primary gout as compared with primary hyperlipoproteinaemia with primary hyperlipoproteinaemia (69% v 43%, p less than 0.01). The independent and relative influences of clinical data of the patients upon the concentrations of serum lipids were assessed by stepwise multiple regression analysis. Two major predictors of serum TG level were alcohol intake (p less than 0.01) and serum uric acid level (p less than 0.05). The most significant predictive variable was alcohol intake, but its influence was judged to be small (r2 = 0.067). None of the other variables, including obesity index, had any significant influence. The relationships between any of these variables and serum TC or HDL-C levels were not significant. In addition, serum lipid levels were investigated in patients with neither obesity (defined as 120% or more of ideal body weight) nor a history of alcohol intake. Their serum TG and TC concentrations were also significantly higher than the respective control levels. Thus hyperlipoproteinaemia in primary gout its unlikely to be secondary to excess alcohol intake or obesity, or both. Instead, it may result from genetic factors such as a combined hyperlipidaemic trait.
对108例男性原发性痛风患者治疗前的血清脂蛋白谱进行了研究，以阐明并存的高脂蛋白血症各型的患病率及其致病因素。痛风患者的血清甘油三酯（TG）和总胆固醇（TC）平均水平分别为2.10±0.14 mmol/L和5.26±0.10 mmol/L（均值±标准误），显著高于年龄匹配的无痛风对照组（分别为1.30±0.07 mmol/L和4.77±0.08 mmol/L）（p均＜0.01和p＜0.05）。痛风患者的血清高密度脂蛋白胆固醇（HDL-C）值与对照组相比略有降低（1.24±0.08 mmol/L对(1.40±0.03 mmol/L)，p＜0.05）。61例患者（56%）出现高脂蛋白血症，其中IIa型、IIb型和IV型高脂蛋白血症患者分别占13%、15%和69%。因此，与原发性高脂蛋白血症相比，原发性痛风中IV型高脂蛋白血症的患病率较高（69%对43%，p＜0.01）。通过逐步多元回归分析评估患者临床数据对血脂浓度的独立和相对影响。血清TG水平的两个主要预测因素是酒精摄入量（p＜0.01）和血清尿酸水平（p＜0.05）。最显著的预测变量是酒精摄入量，但其影响较小（r² = 0.067）。包括肥胖指数在内的其他变量均无显著影响。这些变量与血清TC或HDL-C水平之间均无显著关系。此外，对既无肥胖（定义为理想体重的120%或更高）也无饮酒史的患者进行了血脂水平研究。他们的血清TG和TC浓度也显著高于各自的对照水平。因此，原发性痛风中的高脂蛋白血症不太可能继发于过量饮酒或肥胖，或两者兼而有之。相反，它可能是由遗传因素如合并的高脂血症性状导致的。
