Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
Department of Endocrinology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
BMC Endocr Disord. 2024 Aug 2;24(1):137. doi: 10.1186/s12902-024-01672-8.
The purpose of this study was to investigate the relationships between generalized, abdominal, and visceral fat obesity and the prevalence of gout in patients with type 2 diabetes mellitus (T2DM).
Data were obtained from the electronic medical databases of the National Metabolic Management Center (MMC) of Yuhuan Second People's Hospital and Taizhou Central Hospital (Taizhou University Hospital) between September 2017 and June 2023. Four obesity indicators were analyzed: waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and visceral fat area (VFA). The relationships between these parameters and gout prevalence were analyzed using multivariate logistic regression and restricted cubic spline (RCS) analyses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of the four parameters for gout.
This cross-sectional study enrolled 10,535 participants (600 cases and 9,935 controls). Obesity was more common in patients with gout, and the obesity indicators were markedly higher in this group. After adjustment for confounders, obesity, as defined by BMI, WC, WHR, and VFA, was found to be associated with greater gout prevalence, with odds ratios (OR) of 1.775, 1.691, 1.858, and 1.578, respectively (P < 0.001). The gout odds ratios increased markedly in relation to the obesity indicator quartiles (P-value for trend < 0.001), and the obesity indicators were positively correlated with gout prevalence, as shown using RCS. The area under the ROC curve values for BMI, WC, WHR, and VFA were 0.629, 0.651, 0.634, and 0.633, respectively.
Obesity-whether general, abdominal, or visceral fat obesity-was positively linked with elevated gout risk. But uncovering the causality behind the relationship requires further prospective study. Obesity indicators (BMI, WC, WHR, and VFA) may have potential value for diagnosing gout in clinical practice.
本研究旨在探讨 2 型糖尿病（T2DM）患者全身肥胖、腹部肥胖和内脏脂肪肥胖与痛风患病率之间的关系。
数据来源于玉环市第二人民医院和台州中心医院（台州学院附属医院）国家代谢性疾病管理中心（MMC）的电子病历数据库，时间为 2017 年 9 月至 2023 年 6 月。分析了 4 项肥胖指标：腰围（WC）、腰臀比（WHR）、体质指数（BMI）和内脏脂肪面积（VFA）。采用多因素 logistic 回归和受限立方样条（RCS）分析这些参数与痛风患病率之间的关系。采用受试者工作特征（ROC）曲线评估 4 项参数对痛风的诊断效能。
本横断面研究纳入了 10535 名参与者（600 例病例和 9935 例对照）。痛风患者中肥胖更为常见，且该组肥胖指标明显更高。在调整混杂因素后，BMI、WC、WHR 和 VFA 定义的肥胖与更高的痛风患病率相关，比值比（OR）分别为 1.775、1.691、1.858 和 1.578（P<0.001）。随着肥胖指标四分位数的增加，痛风的 OR 显著增加（趋势 P 值<0.001），并且 RCS 显示肥胖指标与痛风患病率呈正相关。BMI、WC、WHR 和 VFA 的 ROC 曲线下面积值分别为 0.629、0.651、0.634 和 0.633。
全身性肥胖、腹部肥胖和内脏脂肪肥胖均与痛风风险升高呈正相关。但要揭示这种关系背后的因果关系还需要进一步的前瞻性研究。肥胖指标（BMI、WC、WHR 和 VFA）在临床上可能具有诊断痛风的潜在价值。
