الملخص
@#【Objective】To explore clinical manifestations and features of renal uric acid excretion in gout patients with obesity.【Methods】Totally 228 primary gout patients were enrolled and divided into three groups according to body mass index(BMI). Clinical and fasting blood biochemical analysis data were collected. Indices of renal uric acid excretion were calculated according to 24 h urinary uric acid and urinary creatinine.【Results】The obese group(n = 44)was younger than overweight group(n = 88)and non-overweight group(n = 96)[43(32,57)years vs 55(45,65)years,58(45,67)years],with earlier onset age[37(26,48)years vs 48(38,59)years],higher serum uric acid[594(522,697)μmol/L vs 511(372,653)μmol/L]and had more hypercholesterolemia(56.8% vs 31.3%)and low density lipoproteinemia(59.1% vs 47.9%)compared with non-overweight group. The ratio of hypertriglyceridemia(43.5% and 37.5% vs 17.7%)and metabolic syndrome(50.0% and 36.4% vs 12.5%)in the overweight and obese group were both higher than non- overweight group. Fraction excretion of uric acid(FEUA)in obese group[5.5(3.6,7.4)% vs 7.0(5.2,9.8)%]was lower than non-overweight group,and the glomerular filtration load of uric acid[5.3(4.2,7.5)mg·min- 1 ·1.73 m- 2 vs 3.5(2.2,5.2)mg·min-1·1.73 m-2]in obese group was higher than that in non-overweight group(All P < 0.0167). Multivariate regression analysis showed that overweight or obesity were negatively correlated with FEUA(All P < 0.05).【Conclusion】High uric acid load of serum and glomerular filtration in gout patients with obesity may be due to the relative insufficiency of renal uric acid excretion.