河南省郑州市居民痛风相关危险因素的病例对照研究

摘要:目的　了解河南省郑州市居民痛风相关危险因素，为痛风预防控制措施的制定提供科学依据。方法　采用非配对病例对照研究的方法，于2013年 1月-2014年1月在郑州市随机选取5家医院内分泌及风湿科门诊确诊的87例痛风患者作为病例，同时，选取年龄相近、同民族、同一时间在相应医院就诊的87例胃肠炎患者作为对照，进行社会人口学及饮食生活习惯的问卷调查，相关生化指标和基因多态性测定，并进行多重Logistic 回归分析。结果　与对照组相比较，病例组体质指数、血胆固醇、甘油三酯含量，血尿酸含量，空腹血糖浓度及血压均明显增高（P＜0.05），多元Logistic 回归结果表明，有高尿酸血症/痛风家族史，喝啤酒量较大，经常食用动物内脏、浓肉汤、豆制品者，尿酸盐转运子1（URAT1）rs3825018（G/T）G等位基因、脂肪量与肥胖相关基因（FTO）rs17817449（G/T）G等位基因是痛风发生的危险因素，Toll样受体4（TLR4）rs2149356（G/T）G等位基因是痛风发生的保护因素。结论　郑州市居民痛风发生的危险因素涉及饮食习惯、血脂、血糖、血压指标以及遗传基因多态性等多个方面，在痛风的预防及治疗中应采取综合防控措施。

Risk factors in gout patients of Zhengzhou City: A case-control study

Abstract: Objective To explore the relative risk factors in gout patients of Zhengzhou City, and to provide scientific basis for gout prevention and control. Methods Case-control study was adopted to investigate gout patients from 5 hospitals in Zhengzhou from January 2013 to January 2014. The patients with gastroenteritis were served as control group according to similar age and same race at the same time. The questionnaire, biochemical test and genetic polymorphism test were used to investigate 87 cases and controls. The data were analyzed with multiple logistic regression analysis. Results Compared with the control group, body mass index, blood cholesterol, triglyceride levels, blood uric acid levels, fasting glucose concentrations and blood pressure of the case group significantly increased. The results of multiple logistic regression analysis indicated that the risk factors of gout were directly related with high blood uric acid disease/gout family history (OR=6.825, 95% CI: 1.836-25.377), large amount of beer drinking (OR=1.482, 95% CI: 1.005-2.184), regular consumption of animal organs (OR=1.674, 95% CI: 1.161-2.414), concentrated broth (OR=1.495, 95% CI: 1.133-1.973), bean products (OR=1.627, 95% CI: 1.067-2.480), and urate transporter 1 (URAT1) rs3825018 (G/T) G allele (OR=1.919, 95% CI: 1.006-3.661). Fat mass and obesity-related genes (FTO) rs17817449 (G/T) G allele (OR=3.099, 95% CI: 1.507-6.373) were also risk factors of gout occurs, while Toll-like receptor 4 (TLR4) rs2149356 (G/T) G allele was a protective factor of gout occurs. Conclusion The risk factors of gout are involved in diet, blood lipid, blood glucose, blood pressure and genetic polymorphisms in Zhengzhou City residents. The comprehensive prevention and control measures should be taken in the prevention and treatment of gout.