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Risk factors of urinary calculi in men with gout
Yu Cao1, Xinxin Han1, Xiaoxue Wang1
1Department of Family Medicine and Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Shuaifuyuan No.1, Dongcheng District, Beijing, 100730, China.
Insights
Men with gout face higher risks of urinary calculi, especially with longer disease duration and dyslipidemia. Distinct gout phenotypes correlate with varying stone prevalence, aiding in personalized management strategies.
Area of Science:
- Nephrology
- Rheumatology
- Urology
Background:
- Gout, a form of inflammatory arthritis, is associated with an increased risk of urinary stone disease.
- Understanding the specific risk factors and patient phenotypes is crucial for effective management.
Purpose of the Study:
- To identify risk factors for urinary calculi in men diagnosed with gout.
- To characterize distinct clinical phenotypes of gout based on comorbidities.
Main Methods:
- A cohort of 454 male gout patients was studied from October 2016 to January 2020.
- Logistic regression analysis was employed to determine associations between patient characteristics and urinary stone disease.
- Cluster analysis identified three distinct gout phenotypes based on nine common comorbidities.
Main Results:
- The prevalence of urinary calculi was 23.6% in the studied gout patient population.
- Longer gout disease duration (≥10 years) and comorbid dyslipidemia significantly increased the risk of urinary calculi.
- Three distinct gout phenotypes were identified: C1 (obesity, dyslipidemia, abnormal liver function; 23.2% stone prevalence), C2 (fewer comorbidities; 13.5% stone prevalence), and C3 (cardiovascular comorbidities; 47.1% stone prevalence).
Conclusions:
- Prolonged gout disease course and the presence of dyslipidemia are significant contributors to urinary stone formation in men with gout.
- The identified gout phenotypes suggest different underlying pathophysiological mechanisms for stone occurrence, informing targeted gout management strategies.
Objective:
To investigate risk factors of urinary calculi in men with gout.
Method:
A study was conducted at a tertiary hospital in Beijing from October 2016 to January 2020. Male gouty patients were included. Logistic regression was used to establish the association between patients' characteristics and urinary stone disease. A cluster analysis was performed to identify distinct phenotypes of gout based on nine common comorbidities.
Result:
The prevalence of calculi was 23.6% among 454 patients. Longer disease courses and comorbid dyslipidemia were associated with an increased risk of urinary calculi, with an OR of 2.76 (95% CI 1.40-5.64) (p = 0.004) for patients with a disease course of 10 years or longer compared with those with a disease course of gout shorter than 1 year, and an OR of 1.71 (95% CI 1.04-2.88) (p = 0.039) for patients with dyslipidemia. Three clinical phenotypes were recognized. Cluster C1 consists of patients with large body mass index, dyslipidemia, and abnormal liver function. The prevalence of stone was 23.2%. Patients in cluster C2 had fewer comorbidities and the lowest stone risk (13.5%). Cluster C3 had more cardiovascular comorbidities and the highest prevalence of stone (47.1%).
Conclusion:
Longer disease course and dyslipidemia contribute to stone risk in men with gout. Three distinct phenotypes represent distinct pathophysiological mechanisms underlying stone occurrence, which would help us to optimize gout management. Key points • Patients with gout have higher risks for urinary stones. This study found that longer disease courses and comorbid dyslipidemia were associated with an increased risk of urinary calculi in largely untreated young men with uncontrolled gout. • This study reveals three distinct phenotypes of gout based on comorbidities. Among all, the group with more cardiovascular comorbidities has the highest prevalence of stones.
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