The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark, and University of Southern Denmark, Odense University Hospital, Odense, Denmark.
The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Arthritis Rheumatol. 2024 May;76(5):806-812. doi: 10.1002/art.42790. Epub 2024 Feb 20.
Despite scarce evidence, guidelines recommend weight loss as a management strategy for patients with gout. We investigated the effect of an intensive dietary intervention on body weight and clinical measures of gout severity in individuals with obesity and gout.
We conducted a 16-week randomized nonmasked parallel-group trial in Denmark, randomly assigning (one-to-one) individuals with obesity and gout to a low-energy diet or a control diet. The primary outcome was change in body weight. Key secondary outcomes were changes in serum urate (SU) level and visual analog scale-assessed pain and fatigue.
Between December 1, 2018, and June 1, 2019, 61 participants were included in the intention-to-treat population and randomly assigned to the intensive diet group (n = 29) or control diet group (n = 32). Participants had a mean age of 60.3 (SD 9.9) years and mean body mass index of 35.6 (SD 5.0), and 59 (97%) were men. After 16 weeks, there was a significant difference in change in body weight between the diet and control groups (-15.4 vs -7.7 kg; difference -7.7 kg [95% confidence interval -10.7 to -4.7], P < 0.001). Despite results being potentially in favor of a low-energy diet, we could not confirm differences in SU level changes and fatigue between groups. No differences in pain and gout flares were observed between groups. No serious adverse events or deaths occurred during the trial.
An intensive dietary intervention was safe and effectively lowered body weight in people with obesity and gout, but the weight loss did not directly translate into effects on SU level, fatigue, and pain.
尽管证据有限，但指南仍推荐将体重减轻作为痛风患者的一种管理策略。我们研究了强化饮食干预对肥胖和痛风患者的体重和痛风严重程度的临床指标的影响。
我们在丹麦进行了一项为期 16 周的随机、非盲、平行组试验，将肥胖和痛风患者随机分为低能量饮食组或对照组。主要结局为体重变化。关键次要结局为血清尿酸（SU）水平变化以及视觉模拟量表评估的疼痛和疲劳变化。
2018 年 12 月 1 日至 2019 年 6 月 1 日期间，61 名参与者被纳入意向治疗人群，并随机分为强化饮食组（n=29）或对照组（n=32）。参与者的平均年龄为 60.3（9.9）岁，平均体重指数为 35.6（5.0），59 名（97%）为男性。16 周后，饮食组和对照组的体重变化差异有统计学意义（-15.4 与-7.7 kg；差值-7.7 kg[95%置信区间-10.7 至-4.7]，P<0.001）。尽管结果可能有利于低能量饮食，但我们无法确认 SU 水平变化和疲劳方面两组之间的差异。两组之间疼痛和痛风发作无差异。试验期间未发生严重不良事件或死亡。
强化饮食干预安全有效，可降低肥胖和痛风患者的体重，但体重减轻并未直接转化为 SU 水平、疲劳和疼痛的影响。
