Wen Wen, Ma Liwen, Dang Wantai, Lei Ping, Hu Jing, Liu Jian
Department of Ultrasound, First Affiliated Hospital, Clinical Medical College of Chengdu Medical College, Chengdu, China.
Department of Ultrasonic Medicine, Chengdu Wenjiang District People's Hospital, Chengdu, China.
Front Med (Lausanne). 2024 Nov 20;11:1477220. doi: 10.3389/fmed.2024.1477220. eCollection 2024.
This study aimed to compare the imaging features of bilateral knees, ankles, and the first metatarsophalangeal joint using high-frequency ultrasonography in male patients with familial and sporadic primary gout and sought to elucidate the relationship between the presence of tophi and various clinical indicators.
Male patients with primary gouty arthritis (GA) in the acute phase presenting to the Department of Rheumatology and Immunology at the First Affiliated Hospital of Chengdu Medical College from November 2020 to June 2022 were enrolled and classified into familial and sporadic gout groups. Comparative analyses of their clinical data and ultrasonographic imaging findings of the knees, ankles, and first metatarsophalangeal joints were performed between the groups. Univariate and multivariate logistic regression analyses, as well as receiver operating characteristic (ROC) analysis, were conducted to determine the effectiveness of significant factors in the prediction of tophi.
In comparison to male patients with sporadic gout, those with familial primary gout exhibited lower age, body mass index, disease duration, and serum uric acid (SUA) levels. However, they demonstrated higher incidences of tophi and bone erosion (54.6% in familial gout vs. 35.1% in sporadic gout, < 0.05; 71.2% in familial gout vs. 48.1% in sporadic gout, < 0.05, respectively), with a greater prevalence of tophi in the right first metatarsophalangeal joint (44.2% in familial gout vs. 32.3% in sporadic gout, < 0.05). Independent risk factors for tophi included family history (OR = 6.712), age (OR = 1.049), disease duration (OR = 1.134), and SUA levels (OR = 1.006). ROC analysis yielded an area under the curve of 0.883 ( < 0.05) for predicting joint tophi using these factors.
Male patients with familial primary GA in the acute phase experienced earlier onset, shorter disease duration compared to those with sporadic gout. They also had more affected joints, more frequent and a wider distribution of tophi, especially in the right first metatarsophalangeal joint. Family history, age, disease duration, and SUA levels are predictive of tophi formation.
本研究旨在比较高频超声检查在男性家族性和散发性原发性痛风患者双侧膝关节、踝关节及第一跖趾关节的影像学特征，并试图阐明痛风石的存在与各种临床指标之间的关系。
纳入2020年11月至2022年6月在成都医学院第一附属医院风湿免疫科就诊的急性期原发性痛风性关节炎（GA）男性患者，并分为家族性痛风组和散发性痛风组。对两组患者的临床资料以及膝关节、踝关节和第一跖趾关节的超声影像学检查结果进行比较分析。进行单因素和多因素逻辑回归分析以及受试者工作特征（ROC）分析，以确定各显著因素在预测痛风石方面的有效性。
与散发性痛风男性患者相比，家族性原发性痛风患者的年龄、体重指数、病程和血清尿酸（SUA）水平较低。然而，他们的痛风石和骨质侵蚀发生率较高（家族性痛风为54.6%，散发性痛风为35.1%，P<0.05；家族性痛风为71.2%，散发性痛风为48.1%，P<0.05），痛风石在右侧第一跖趾关节的患病率更高（家族性痛风为44.2%，散发性痛风为32.3%，P<0.05）。痛风石的独立危险因素包括家族史（OR=6.712）、年龄（OR=1.049）、病程（OR=1.134）和SUA水平（OR=1.006）。ROC分析显示，利用这些因素预测关节痛风石的曲线下面积为0.883（P<0.05）。
急性期家族性原发性GA男性患者与散发性痛风患者相比发病更早，病程更短。他们还存在更多受累关节，痛风石更频繁且分布更广，尤其是在右侧第一跖趾关节。家族史、年龄、病程和SUA水平可预测痛风石的形成。
