Wei Jie, Wang Yilun, Dalbeth Nicola, Xie Junqing, Wu Jing, Zeng Chao, Lei Guanghua, Zhang Yuqing
Xiangya Hospital, Central South University, the Hunan Key Laboratory of Joint Degeneration and Injury, the Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, and the Xiangya School of Public Health, Central South University, Changsha, China.
Xiangya Hospital, Central South University, the Hunan Key Laboratory of Joint Degeneration and Injury, and the Key Laboratory of Aging-Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
Arthritis Rheumatol. 2025 Mar;77(3):335-345. doi: 10.1002/art.42996. Epub 2024 Nov 11.
Weight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among individuals who were overweight and obese remains unknown. We investigate the relationship between weight loss rate following treatment with anti-obesity medications and the risk of incident gout and recurrent gout flares among individuals who were overweight or obese.
Using data from the Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication. We emulated a target trial to examine the association of different weight loss rates, slow (2%-5%), moderate (5%-10%), or fast (≥10%), within the first year of treatment with incident gout and recurrent gout flares during a 5 year follow-up period.
Among 131,000 participants without gout being treated with orlistat, the 5-year risk of incident gout was 1.6% for those with weight gain or stability, compared with 1.5%, 1.3%, and 1.2% for those with slow, moderate, and fast weight loss, respectively. Compared with the group with weight gain or stability, the hazard ratios were 0.91 (95% confidence interval [CI] 0.81-1.01), 0.82 (95% CI 0.72-0.92), and 0.73 (95% CI 0.62-0.86) for those with a slow, moderate, and fast rate of weight loss, respectively. Similar results were observed for the recurrent gout flares among 3,847 individuals with overweight or obese with gout treated with orlistat.
A higher rate of weight loss after receiving treatment with orlistat within 1 year was associated with lower risks of incident gout and lower rates of recurrent gout flares among overweight or obese people.
有条件推荐减重用于痛风管理；然而，其对超重和肥胖个体新发痛风及痛风复发的影响尚不清楚。我们研究了使用抗肥胖药物治疗后的减重率与超重或肥胖个体新发痛风及痛风复发风险之间的关系。
利用健康改善网络的数据，我们选择了18岁及以上超重或肥胖且开始使用抗肥胖药物的个体。我们模拟了一项目标试验，以检验在治疗的第一年内不同减重率（缓慢减重2%-5%、中度减重5%-10%或快速减重≥10%）与5年随访期内新发痛风及痛风复发之间的关联。
在131,000名接受奥利司他治疗且无痛风的参与者中，体重增加或稳定者5年新发痛风风险为1.6%，而缓慢减重、中度减重和快速减重者的风险分别为1.5%、1.3%和1.2%。与体重增加或稳定组相比，缓慢减重、中度减重和快速减重者的风险比分别为0.91（95%置信区间[CI]0.81-1.01）、0.82（95%CI 0.72-0.92）和0.73（95%CI 0.62-0.86）。在3,847名接受奥利司他治疗的超重或肥胖痛风患者中，痛风复发情况也观察到了类似结果。
超重或肥胖人群在接受奥利司他治疗1年内较高的减重率与较低的新发痛风风险及较低的痛风复发率相关。
