Fukui Sho, Okada Masato, Shinozaki Tomohiro, Suzuki Takahiro, Nakai Takehiro, Ozawa Hiroki, Tamaki Hiromichi, Kishimoto Mitsumasa, Hasegawa Hiroshi, Matsuda Takeaki, Marrugo Javier, Tedeschi Sara K, Choi Hyon K, Solomon Daniel H
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, St. Luke's International Hospital, Tokyo, Japan, Kyorin University School of Medicine, Tokyo, Japan.
St. Luke's International Hospital, Tokyo, Japan.
Arthritis Rheumatol. 2025 Mar;77(3):346-355. doi: 10.1002/art.43027. Epub 2024 Oct 31.
Our objective was to evaluate associations of weight reduction with serum urate (SU) changes and achieving an SU level <6 mg/dL in the real-world setting, outside of specific weight reduction interventions.
We analyzed systematically collected data of annual medical examination participants from October 2012 to October 2022. Exposure was weight change (increase or decrease) between two consecutive visits, categorized as minimal (≤0.9 kg, reference), small (1.0-4.9 kg), moderate (5.0-9.9 kg), and large (≥10 kg). Outcomes included SU changes between two consecutive visits and achieving an SU level <6 mg/dL in participants with hyperuricemia (SU level ≥7 mg/dL at the previous visit).
We identified 58,630 eligible participants (median age 46 years, 51.3% female, 19.4% with overweight, median SU level 5.3 mg/dL, and 5.6% with a history of gout and/or hyperuricemia) with 336,814 visits over a median of 5.3 years. After adjustment for relevant covariates, linear general estimating equations estimated mean SU changes based on observed weight reductions (vs minimal changes) were as follows: small, -0.10 mg/dL (95% confidence interval [CI] -0.10 to -0.09 mg/dL); moderate, -0.34 mg/dL (95% CI -0.36 to -0.32 mg/dL); and large, -0.64 (95% CI -0.70 to -0.58 mg/dL). In participants with hyperuricemia, adjusted relative risks for achieving an SU level <6 mg/dL by modified Poisson regression were 1.25 (95% CI 1.15-1.37) in small weight reductions, 2.82 (95% CI 2.43-3.27) in moderate weight reductions, and 5.27 (95% CI 4.15-6.70) in large weight reductions, with corresponding numbers needed to treat of 61.1 for small weight reductions, 8.5 for moderate weight reductions, and 3.6 for large weight reductions.
Small weight reductions were associated with only small SU changes. Some participants with hyperuricemia can achieve the target SU level with moderate to large weight reductions.
我们的目的是在现实环境中，在没有特定减肥干预措施的情况下，评估体重减轻与血清尿酸（SU）变化以及SU水平降至<6mg/dL之间的关联。
我们分析了2012年10月至2022年10月系统收集的年度体检参与者的数据。暴露因素为两次连续就诊之间的体重变化（增加或减少），分为极小变化（≤0.9kg，参考值）、小变化（1.0 - 4.9kg）、中度变化（5.0 - 9.9kg）和大变化（≥10kg）。结局包括两次连续就诊之间的SU变化，以及高尿酸血症参与者（上次就诊时SU水平≥7mg/dL）的SU水平降至<6mg/dL。
我们确定了58,630名符合条件的参与者（中位年龄46岁，51.3%为女性，19.4%超重，中位SU水平5.3mg/dL，5.6%有痛风和/或高尿酸血症病史），在中位5.3年期间进行了336,814次就诊。在调整相关协变量后，线性广义估计方程根据观察到的体重减轻情况（与极小变化相比）估计的平均SU变化如下：小变化，-0.10mg/dL（95%置信区间[CI] -0.10至-0.09mg/dL）；中度变化，-0.34mg/dL（95%CI -0.36至-0.32mg/dL）；大变化，-0.64mg/dL（95%CI -0.70至-0.58mg/dL）。在高尿酸血症参与者中，通过修正泊松回归分析，体重小幅度减轻达到SU水平<6mg/dL的调整后相对风险为1.25（95%CI 1.15 - 1.37），体重中度减轻为2.82（95%CI 2.43 - 3.27），体重大幅度减轻为5.27（95%CI 4.15 - 6.70），相应的治疗所需人数分别为小幅度减轻61.1、中度减轻8.5、大幅度减轻3.6。
小幅度体重减轻仅与SU的小幅度变化相关。一些高尿酸血症参与者通过中度至大幅度体重减轻可达到目标SU水平。
