ABSTRACT
Objective:To explore early-onset gout and related risk factors in Shandong Province, and provide decision-making information on prevention.Methods:Data from electronic medical records and face-to face interview were collected from 8 393 patients with gout who first visited the gout clinic of the Affiliated Hospital of Qingdao University from September 2016 to December 2021. Data included demographics, comorbidity and biochemical examinations. The dynamic changes of onset age from 2002 to 2021 were statistically analyzed. The clinical characteristics and related risk factors of patients with early-onset and late-onset gout were statistically analyzed.Results:The age of onset of gout decreased significantly from 2002 to 2021. Compared with 2002, the average age of onset in 2021 decreased by 2.3 years [(41.9±10.6 vs 39.6±14.0) years]. The median age of onset decreased by 3 years in 2012-2021 compared with 2002-2011(37 vs 40 years, P<0.001). The proportion of gout patients with onset age<40 years old increased significantly, from 45.1% in 2002 to 57.8%, and increased by 12.7% in 20 years( P<0.001). The constituent ratios of 20-29 years old group( Ptrend<0.001) and≤19 years old group( Ptrend=0.011) increased by 9.3%( P<0.001) and 4.2%( P=0.002) over 20 years, which was the highest increase among all age groups with onset age<40 years old. Multivariate stepwise linear regression analysis showed that positive family history, blood uric acid level, metabolic syndrome and smoking were independent risk factors for early onset of gout. Conclusion:The age of gout onset in tends to be younger. The increase of the proportion of patients younger than 30 years old is probably the key factor leading to the early-onset gout in Shandong Province. Early and effective intervention on the risk factors related to early-onset gout is essential to prevent the early-onset gout as well as to reduce the prevalence of gout and complications.
ABSTRACT
Objective:To investigate the effect of urate-lowering therapy (ULT) on body fat and visceral fat areas in patients with gout and to analyze the related risk factors.Methods:A total of 140 patients with gout eligible for enrollment were recruited from the gout clinic in the Affiliated Hospital of Qingdao University from Sept. 2018 to Sept. 2019. After 2 weeks of washout, all patients were treated with benzbromarone for consecutive 12 weeks. The data of blood biochemical, body fat (BF), body fat percentage (BFP) and visceral fat area (VFA) were collected, and the differences before and after ULT as well as the risk factors affecting the changes of BF, BFP, and VFA were analyzed.Results:The diastolic blood pressure (DBP), alanine aminotransferase (ALT), serum uric acid (sUA), BF, BFP, and VFA were significantly decreased after ULT ( P<0.05). The results of multivariate stepwise linear regression analysis showed that sUA, creatinine (Cr) and glomerular filtration rate (eGFR) were independent risk factors affecting the improvement of BF and VFA (P<0.05). Lower serum uric acid levels in patients with gout before and after ULT indicated better improvement effect of body fat and visceral fat areas( P<0.05). Conclusion:Gout combined with hyperuricemia is closely related to visceral obesity. In addition to lowering the serum uric acid level, ULT could also benefit the body fat and visceral fat area in patients with gout to some extent.
ABSTRACT
Atherosclerosis is a chronic inflammatory disease,with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens.Subsequent investigations have revealed that an immunomodulatory strategy via active immunization against atherosclerotic plaque antigen(s) could potentially alleviate atherosclerosis.Substantial data from clinical investigations support the key role of immune system in atherosclerosis.So,it may be promising to develop immunotherapy against atherosclerosis.The paper reviews current status of immunization studies and possible associated immunemediated inflammatory mechanisms in atherosclerosis.