Kaneshita Shunya, Fukui Sho, Niku Soheil, Lee Kwanghoon, Belezzuoli Ernest, Terkeltaub Robert, Guma Monica
University of California San Diego, La Jolla, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, Kyorin University and St. Luke's International Hospital, Tokyo, Japan.
Arthritis Care Res (Hoboken). 2025 Aug;77(8):1022-1031. doi: 10.1002/acr.25540. Epub 2025 May 9.
We evaluate the F-fluorodeoxyglucose positron emission tomography (PET) standardized uptake value (SUV) by PET/computed tomography (CT) scans in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in patients with and without gout. Additionally, we investigate whether glucose uptake in these tissues predicts the progression of chronic kidney disease (CKD).
We used International Classification of Diseases, Tenth Revision codes from the University of California San Diego patient database to identify patients with gout and controls, forming a cohort of individuals who underwent PET/CT scans. The mean VAT and SAT maximum SUV (SUVmax) were measured using PET/CT scans and adjusted for potential confounders using inverse probability of weighting analysis. We also employed multivariable linear regression to analyze changes in estimated glomerular filtration rate (eGFR) after PET/CT scans.
The study included 221 patients, with 120 diagnosed with gout. After the inverse probability of weighting adjustment, the mean VAT and SAT SUVmax were higher in patients with gout (mean VAT SUVmax: β = 0.09, 95% confidence interval [CI] 0.04-0.15; mean SAT SUVmax: β = 0.06, 95% CI 0.01-0.12). Additionally, in patients with gout with CKD stage ≥3, higher mean VAT and SAT SUVmax were associated with decreased eGFR in the 5 years following PET/CT scans (mean VAT SUVmax: β = -1.76, 95% CI -3.50 to -0.01; mean SAT SUVmax: β = -2.97, 95% CI -5.61 to -0.32).
Elevated glucose uptake-associated metabolic activity in both VAT and SAT was observed in patients with gout, which may contribute to CKD progression among patients with both gout and CKD.
我们通过正电子发射断层扫描/计算机断层扫描（PET/CT）评估痛风患者和非痛风患者内脏脂肪组织（VAT）和皮下脂肪组织（SAT）中的氟脱氧葡萄糖正电子发射断层扫描（PET）标准化摄取值（SUV）。此外，我们研究这些组织中的葡萄糖摄取是否能预测慢性肾脏病（CKD）的进展。
我们使用加利福尼亚大学圣地亚哥分校患者数据库中的国际疾病分类第十版编码来识别痛风患者和对照组，组成一个接受PET/CT扫描的队列。使用PET/CT扫描测量VAT和SAT的平均最大SUV（SUVmax），并通过加权分析的逆概率对潜在混杂因素进行调整。我们还采用多变量线性回归分析PET/CT扫描后估计肾小球滤过率（eGFR）的变化。
该研究纳入了221名患者，其中120名被诊断为痛风。经过加权调整的逆概率分析后，痛风患者的VAT和SAT平均SUVmax更高（平均VAT SUVmax：β = 0.09，95%置信区间[CI] 0.04 - 0.15；平均SAT SUVmax：β = 0.06，95% CI 0.01 - 0.12）。此外，在CKD分期≥3的痛风患者中，较高的VAT和SAT平均SUVmax与PET/CT扫描后5年内eGFR降低相关（平均VAT SUVmax：β = -1.76，95% CI -3.50至 -0.01；平均SAT SUVmax：β = -2.97，95% CI -5.61至 -0.32）。
痛风患者的VAT和SAT中均观察到与葡萄糖摄取相关的代谢活性升高，这可能导致痛风合并CKD患者的CKD进展。
