Hong Kai-Deng, Peng Jin-Hui, He Qi-Da, Zhou Jin-Lan, Wang Shan-Qin, Liu Na, Gui Teng-Juan, Zhe Xing-Wei
Division of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China.
Department of Infectious Diseases and Public Health, City University of Hong Kong, Kowloon, Hong Kong.
Medicine (Baltimore). 2025 Aug 8;104(32):e43730. doi: 10.1097/MD.0000000000043730.
There is limited research to investigate the relationship between blood urea nitrogen (BUN) levels and gout, especially there was no study to establish a causal relationship. The aim of our study is to explore the associations between BUN levels and gout risk using observational and Mendelian randomization (MR) analyses. In the observational analyses, we used data from the 2007 to 2018 survey cycles of the National Health and Nutrition Examination Survey (NHANES) and recruited 31,245 participants aged ≥ 20 years. Logistic regression, subgroup analyses, restricted cubic spline (RCS), and the 2-sample MR analysis were used to examine the association between BUN levels with gout. Our cross-sectional study found that each standard deviation increase in BUN was linked to an elevated risk of gout after adjusting for covariates (odds ratio [OR] = 1.02, 95% confidence intervals [CI] = 1.01-1.03, P < .001). In subgroup analyses, stronger associations between BUN and gout were identified in female, hypertension, diabetes, and chronic kidney disease (CKD) (all P < .05). In addition, the RCS revealed positive non-linear relationship between BUN and gout. The 2-sample MR analyses results suggested that there were positive causal relationships between BUN and gout using the Inverse variance weighted (IVW) method (OR = 9.12, 95% CI = 2.00-41.52], P = .0042), (OR = 5.98, 95% CI = 2.15-16.62, P = .0006]), and (OR = 1.43, 95% CI = 1.02-1.92], P = .0367). Our study found the robust and causal relationship between BUN levels and the risk of gout. These results suggest that BUN can be used as a feasible indicator for predicting gout.
关于研究血尿素氮(BUN)水平与痛风之间关系的研究有限,尤其是尚无研究来确定二者之间的因果关系。我们研究的目的是通过观察性分析和孟德尔随机化(MR)分析来探索BUN水平与痛风风险之间的关联。在观察性分析中,我们使用了2007年至2018年国家健康与营养检查调查(NHANES)的调查周期数据,并招募了31245名年龄≥20岁的参与者。采用逻辑回归、亚组分析、限制性立方样条(RCS)和两样本MR分析来检验BUN水平与痛风之间的关联。我们的横断面研究发现,在校正协变量后,BUN每增加一个标准差,痛风风险就会升高(优势比[OR]=1.02,95%置信区间[CI]=1.01-1.03,P<.001)。在亚组分析中,在女性、高血压、糖尿病和慢性肾脏病(CKD)患者中发现BUN与痛风之间存在更强的关联(所有P<.05)。此外,RCS显示BUN与痛风之间存在正非线性关系。两样本MR分析结果表明,使用逆方差加权(IVW)方法时,BUN与痛风之间存在正因果关系(OR=9.12,95%CI=2.00-41.52,P=.0042),(OR=5.98,95%CI=2.15-16.62,P=.0006),以及(OR=1.43,95%CI=1.02-1.92,P=.0367)。我们的研究发现BUN水平与痛风风险之间存在稳健的因果关系。这些结果表明,BUN可作为预测痛风的一个可行指标。
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