2.Clinical characteristics in gout patients with different body mass index
Lidan MA ; Ruixia SUN ; Ying XIN ; Yuan WANG ; Changgui LI ; Tian LIU ; Xiaoyu CHENG ; Zhaotong JIA
Chinese Journal of Internal Medicine 2017;56(5):353-357
Objective Obesity is one of the risk factors for gout.The aim of the present study was to evaluate clinical characteristics of gout patients with different BMI.Methods A total of 5 104 patients with gout were enrolled and divided into three groups according to the BMI.The clinical information was collected and relevant biochemical indices were detected.SPSS software was applied for the statistical analyses.Results There were significant differences in the ratios of gender,regular exercise,hypertension,tophus,renal insufficiency,hyperlipidemia,impaired glucose metabolism,liver dysfunction among the three groups (all P<0.01).The onset age in overweight [45(36,55) years] and obese subjects [40(31,50)years] were earlier than that of the normal weight subjects [50 (38,61) years].Moreover,waist circumstances [103(99,108) cm and 94 (90,98) cm vs 87 (82,91) cm],systolic pressure [130 (120,145) mmHg (1 mmHg =0.133 kPa) and 130 (120,140) mmHg vs 128 (115,140) mmHg],diastolic pressure [90 (80,100) mmHg and 85 (80,92) mmHg vs 80 (79,90) mmHg],fasting blood glucose [5.77 (5.30,6.44) mmol/L and 5.65 (5.19,6.26) mmol/L vs 5.55 (5.10,6.15) mmol/L],TG [2.10 (1.46,3.04) mmol/L and1.88 (1.35,2.78) mmol/L vs 1.52 (1.07,2.39) mmol/L],TC [5.20 (4.55,5.93) mmol/L and 5.07 (4.46,5.75) mmol/L vs 4.95 (4.27,5.65) mmol/L],serum uric acid [483(418,552) μmol/L and461(395,524) μmol/L vs440 (368,517) μmol/L],ALT [30 (21,46) U/L and25 (18,36) U/L vs 21 (14,29) U/L],AST [21(17,28) U/L and 20 (17,26) U/L vs 20 (6,25) U/L],the number of joints involved [2 (1,3) joints and 2 (1,2) joints vs 1 (1,2) joints] in the overweight and obese groups were higher than those in the normal weight group (all P < 0.01).There were no statistical differences in family history,involvement of upper limb joints,kidney stones and coronary heart disease among the three groups (all P > 0.05).Conclusions Obesity is associated with an earlier age of gout onset.With the increase of BMI,the blood pressures,glucose,lipid,serum uric acid,liver transaminase levels and the number of involved joints increased gradually.Cautions should be taken in treating patients with different BMI.
3.Analysis of risk factors for susceptibility of subcutaneous tophi in people with gout
Lidan MA ; Xiaoyu CHENG ; Xiuying WU ; Changgui LI ; Zhaotong JIA ; Ying XIN ; Tian LIU ; Ruixia SUN
Chinese Journal of Endocrinology and Metabolism 2017;33(6):497-501
Objective To discuss the risk factors for susceptibility of subcutaneous tophi with an aim to provide clinical evidence for the prevention and treatment of tophi.Methods A total of 5 321 cases of gout patients whose course of disease was less than 10 years were selected and divided into two groups according to whether a subcutaneous tophus was present. The clinical information was collected and relevant biochemical indices were detected.Results There were significant differences in the ratios of regular exercise, involvement of upper limb joints, combining renal insufficiency, kidney stone and coronary heart disease between the tophus group and the non-tophus group(P<0.05 or P<0.01). There were significant statistical differences in age, disease duration, body mass index, systolic blood pressure, diastolic blood pressure, serum uric acid, serum creatinine, creatinine clearance rate, the number of joints involved between the two groups[(51.80±14.58 vs 48.45±14.45)year,(5.61±3.20 vs 3.28±3.06)year,(26.50±3.39 vs 27.05±3.45)kg/m2,(138±20 vs 133±18)mmHg, 1 mmHg=0.133 kPa,(89±13 vs 87±12)mmHg,(486.66±121.96 vs 460.02±119.10) μmol/L,(112.11±62.97 vs 104.43±46.28) μmol/L, (86.46±37.99 vs 93.00±40.11 )ml/min,(2.89±1.86 vs 1.76±1.22) joints, all P<0.01]. There were no statistical differences in family history, gender, history of smoking and drinking, the means of waistline, fasting blood glucose, triglyceride, and total cholesterol between the two groups(all P>0.05). Further logistic regression analysis indicated that disease duration, a large number of joints involved, the involvement of upper limb joints, combining kidney stones, higher serum uric acid level, and higher diastolic pressure were risk factors of the early onset of subcutaneous tophi, while regular exercise and body mass index were protective factors.Conclusion Patients with long duration, high serum level of uric acid, a large number of joints involved, upper limb joint involved, kidney stones, and hypertension were more likely to develop subcutaneous tophi. These risk factors should be intervened actively in clinic.
4.Impact of adenotonsillectomy on quality of life in children with sleep disordered breathing.
Jin YE ; Yuan LI ; Hui LIU ; Xian LIU ; Xiaowen ZHANG ; Zhenlin WANG ; Zhaotong HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2007;21(6):254-258
OBJECTIVE:
To compare improvement in quality of life after adenotonsillectomy in children with similar demographics but with either obstructive sleep apnea hypopnea syndrome (OSAHS) or with milder forms of sleep-disordered breathing (SDB). To evaluate the relationship between polysomnogram (PSG) results and disease-specific quality of life for children with obstructive sleep apnea 18 item survey (OSA-18).
METHOD:
Children with SDB who were suspected of having OSAHS were enrolled. All study participants underwent overnight PSG using standardized techniques. The effectiveness of adenotonsillectomy for the relief of SDB was evaluated by using the OSA-18. Follow-up was assessed at 6-9 months. Preoperative and postoperative OSA-18 scores for each group of children (OSAHS and mild SDB) were compared.
RESULT:
The study population included 51 children with SDB, and 28 of them met PSG criteria for OSAHS, the other 23 of them without OSAHS. The clinical data in the two groups were similar. OSA-18 scores were not significantly different between children with and without OSAHS. The total OSA-18 scores and the scores for all domains showed significant improvement after surgery for both groups of children (P<0.01). A comparison of mean difference in total and domain scores for the two groups of children was not significant (P>0.05). The domains of sleep disturbance, physical suffering and caregiver concerns showed significant association with PSG parameters (P<0.01). But no strong association was identified for OSA-18 total scores and other two domains (P>0.05).
CONCLUSION
Both groups of children showed a dramatic improvement in quality of life after adenotonsillectomy and the degree of improvement was similar. Fortunately, surgical therapy with adenotonsillectomy was associated with marked improvement in quality of life for children with either OSAHS or mild SDB. However, the association between PSG findings and OSA-18 scores was only moderate.
Adenoidectomy
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Adolescent
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Child
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Child, Preschool
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Female
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Humans
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Male
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Quality of Life
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Sleep Apnea Syndromes
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surgery
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Sleep Apnea, Obstructive
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surgery
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Surveys and Questionnaires
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Tonsillectomy
5.Prevalence and prognostic factors for postoperative complications of uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome.
Jin YE ; Ping FANG ; Gehua ZHANG ; Xuekun HUANG ; Tao WANG ; Zhaotong HUANG ; Minqiang XIE ; Yuan LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2008;22(9):393-396
OBJECTIVE:
To explore the complication incidence and risk factors within immediate 24 hours after uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and provide theoretical foundation for preventing postoperative complication incidence.
METHOD:
162 patients undergoing UPPP procedure between Mar, 2002, and Oct 2006, were analysed retrospectively. All patients were divided into two groups according to the development of postoperative complications or not. The retrospective chart review focused on the demographic data and pertinent history, preoperative sleep evaluation, surgical and anesthetic management, and need for postoperative interventions. Potential risk factors were first evaluated with univariate analysis followed by multivariate logistic regression with the occurrence of complications within immediate 24 hours after operation as the dependent variable.
RESULT:
A total of 162 consecutive cases for UPPP were enrolled into current study. 31 cases (19.1%) had postoperative complications necessitating a medical intervention, including respiratory complications (n =21, 13.0%), cardiovascular complications (n =6, 3.7%) and hemorrhage (n =9, 5.6%). The differences in body mass index (BMI), apnea-hypopnea index (AHI), lowest oxygen saturation (LSAT) and difficult intubation were significant between two groups. Risk factors for postoperative complications were BMI (OR =1.136, 95% CI: 1.007-2.558, P =0.049), preoperative AHI (OR =4.828, 95% CI: 1.827-13.924, P =0.012) and difficult intubation (OR = 1.971, 95% CI: 1.251- 4.839, P =0.034).
CONCLUSION
Baseline BMI and AHI, difficult intubation in anaesthetic procedure were the most important predictors of postsurgical morbidity. Keeping in mind the aforementioned cautionary notes, aggressively preoperative preparation should be applied for such populations to avoid the occurrence of postoperative complications.
Adult
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Cleft Palate
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surgery
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Female
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Humans
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Logistic Models
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Male
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Middle Aged
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Otorhinolaryngologic Surgical Procedures
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adverse effects
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Palate
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surgery
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Pharynx
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surgery
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Postoperative Complications
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epidemiology
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Retrospective Studies
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Risk Factors
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Sleep Apnea, Obstructive
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surgery
6.Clinical characteristics and risk factors for young primary gout patients with subcutaneous tophi
Lidan MA ; Tian LIU ; Ying CHEN ; Xiaoyu CHENG ; Ruixia SUN ; Ying XIN ; Changgui LI ; Zhaotong JIA
Chinese Journal of Rheumatology 2021;25(9):590-596
Objective:To analyze the clinical characteristics and risk factors associated with the formation of subcutaneous tophi among young gout patients.Methods:Gout patients treated at the Affiliated Hospital of Qingdao University from September 2016 to June 2020 were included. The clinical information was collected and relevant biochemical indices were detected. Fasting urine was collected to test urine pH value, urine uric acid and urine creatinine. Patients were divided into young tophi group and non-tophi group according to age. The measurement data of normal distribution was expressed as Mean±Standard deviation, and independent sample t test and one-way analysis of variance were used. The counting data was tested by Chi-square test. The risk factors were analyzed by logistic regression. Results:A total of 4 798 primary gout patients were collected. There were 915 patients with subcutaneous tophi, 2 308 young gout patients, 252 young gouty tophi patients among them. The average BMI, waist circumference, hip circumference, triglyceride level, serum uric acid level, glomerular filtration rate, alanineamino -transferase (ALT) and aspartate amino -transferase (AST) in the young tophi group were significantly higher than those in the middle-age tophi group ( F=46.074, 2.551, 9.203, 10.370, 15.118, 68.741, 35.023, 5.175, all P<0.05). Average age of disease onset, systolic blood pressure, fasting blood glucose, urine FEUA, Uua/Ucr and urea nitrogen level in young tophi group were significantly lower than those in middle-age tophi group ( F=474.876, 7.629, 6.441, 34.877, 3.633, 50.867, all P<0.05]. The age [(35±7) years old vs (33±7) years old], disease course [(7±4) years vs (4±3) years], blood pressure [(139±17) mmHg vs (135±16) mmHg], [(90±13) mmHg vs (86±12) mmHg], serum triglyceride [(2.6±2.1) mmol/L vs (2.4±2.0) mmol/L], total cholesterol [(4.9±1.4) mmol/L vs (4.6±1.4) mmol/L], serum uric acid [(547±171) μmol/L vs (490±160) μmol/L], urea nitrogen [(5.0±2.0) mmol/L vs (4.4±1.7) mmol/L], family history (27.0% vs 19.6%) and smoking rate(56.0% vs 48.9%) of tophi patients were significantly higher than those of non-tophi patients in young patients ( t=4.717, P<0.05; t=12.838, P<0.05; t=3.414, P<0.05; t=4.676, P<0.05; t=2.085, P<0.05; t=2.451, P<0.05; t=5.308, P<0.05; t=4.090, P<0.05; χ2=7.423, P<0.05; χ2=4.235, P<0.05) . The age of disease onset [(28±6) years vs (29±7) years] and glomerular filtration rate [(96±21) ml·min -1·1.73 m -2vs (103±21) ml·min -1·1.73 m -2] were statistically significantly lower than those of non-tophi patients ( t=-2.711, P<0.01; t=-4.907, P<0.01). Logistics regression analysis showed that age, course of disease, blood pressure, blood lipids level, serum uric acid level, family history of gout and smoking were risk factors for the formation of tophi in young people. After further adjusted for age, course of disease and family history of gout, it was found that serum uric acid, systolic blood pressure, diastolic blood pressure and urea nitrogen remined risk factors for tophi, while glomerular filtration rate remained a protective factor in young patients. Conclusion:Young tophi patients are always obese and have lipid metabolism disorder. Young patients with high level of serum uric acid and blood pressure, decreased renal function are prone to complicate with subcutaneous tophi. More attention should be paid in clinical practice to prevent or delay the formation of tophi.
7.Analysis of the therapeutic effect and influencing factors of alkalized urine in patients with gout
Tian LIU ; Lidan MA ; Xiaoyu CHENG ; Ying XIN ; Shasha DONG ; Ying CHEN ; Zhaotong JIA ; Ruixia SUN
Chinese Journal of Endocrinology and Metabolism 2020;36(9):761-766
Objective:To investigate the therapeutic effect and influencing factors of alkalized urine in patients with gout, thus providing the basis for the clinical treatmeat.Methods:A total of 90 cases of gout patients in remission without alkalization of urine and lowering uric acid treatment were selected from January 2019 to June 2019. All patients were given a low purine diet (purine intake<200 mg/d). 90 patients were randomly divided into different drugs of alkalized urine groups according to rardom number table: sodium bicarbonate group, taking potassium sodium hydrogen citrate 1.0 g tid; the citrate granule group, taking potassium sodium hydrogen citrate 2.5 g tid; and control group, taking low purine diet only. On the 5th day of treatment, fasting urine in the morning was retained, breakfast was prescribed, and alkalized urine drugs were taken after the meal. Their urine pH was determined at 1 h, 2 h, 3 h, and 4 h after the medicine taken, and copmare the changes of urine pH in different groups. Taking urine pH 6.2 as cut-off point, patients receiving alkalized urine drugs were divided into the standard group (urine pH≥6.2) and the non-standard group (urine pH<6.2) according to their mean urine pH at 2 h, 3 h, and 4 h after taking medicine. Finally, the influencing factors of urine pH were compared between the groups.Results:There were no significant differences in fasting urine pH between the sodium bicarbonate group and the control group, but the urine pH of 2 h and 3 h after sodium bicarbonate taken were significantly higher than the control group ( P<0.05). The urine pH of the citrate granule group was higher than the control group and the sodium bicarbonate group on fasting and at any time after taking drugs ( P<0.05 or P<0.01). The peak pH value of urine in the sodium bicarbonate and citrate granule groups was 4 h after taking drugs, followed by 2 h and 3 h. There were statistically significant differences in body mass index, waist circumference, and blood pressure between the standard and non-standard groups ( P<0.05 or P<0.01). Conclusion:Fasting urine pH alone can not be used as an index for the efficacy of alkalized urine, it is recommended to refer to the pH value of 2-4 h after taking drugs. The efficacy of potassium sodium hydrogen citrate was better than that of sodium bicarbonate. Obesity or overweight seems to be an adverse factor affecting the alkalized urine.
8.Clinical characteristics and risk factors for primary gout patients with multiple subcutaneous tophi
Tian LIU ; Lidan MA ; Xiaoyu CHENG ; Zhaotong JIA ; Ying CHEN ; Changgui LI ; Ruixia SUN
Chinese Journal of Endocrinology and Metabolism 2023;39(11):950-954
Objective:To investigate the clinical characteristics and risk factors of multiple tophi among gout patients.Methods:Gout patients treated at Affiliated Hospital of Qingdao University from September 2017 to September 2021 were included retrospectively. According to the number of tophi, the patients were divided into the multiple tophi group, the single tophi group and the non-tophi group. Clinical data were collected, biochemical indices and urine pH value were determined. One- way ANOVA or Chi-square test was used to compare groups, and multivariate logistic regression was used to analyze the risk factors. Results:The age, disease course, blood pressure, serum uric acid, urea nitrogen, and the rate of family history, smoking, drinking, gout attacks≥2 twice per year, hypertension, cardio-cerebrovascular diseases, kidney stones in the multiple tophi group were significantly higher than those in the single tophi group and the non-tophi group. The glomerular filtration rate, urine pH value and the rate of regular exercise were significantly lower than those of single tophi group and non-tophi group. In the multiple tophi group, 245 cases(44.46%) were involved in the interphalangeal joint or metacarpophalangeal joint, 212 cases(38.47%) were involved in other joints of the upper limb, which was second only to the first metatarsophalangeal joint(349 cases, 63.33%). Logistic regression analysis showed that the course of disease, urea nitrogen, serum uric acid, positive family history, drinking, gout attacks ≥twice per year and hypertension were the risk factors for multiple tophi in gout patients. Conclusion:Patients with a long disease course, elevated uric acid, high urea nitrogen, positive family history, alcohol consumption, frequent gout flare and hypertension are more likely to develop multiple tophi.
9.Association of single nucleotide polymorphisms of susceptibility genes of type 2 diabetes mellitus with liability to gout among ethnic Han Chinese males from coastal region of Shandong.
Lin HAN ; Ruosai XIN ; Jian SUN ; Feng HOU ; Changgui LI ; Xinlin HU ; Zhen LIU ; Yao WANG ; Xinde LI ; Wei REN ; Xuefeng WANG ; Zhaotong JIA
Chinese Journal of Medical Genetics 2015;32(5):711-714
OBJECTIVE To assess the association of single nucleotide polymorphisms (SNPs) of susceptibility genes of type 2 diabetes mellitus (T2DM) with liability to gout among ethnic Han Chinese males from coastal region of Shandong province. METHODS Seven SNPs within the susceptibility genes of T2DM, including rs10773971(G/C) and rs4766398(G/C) of WNT5B gene, rs10225163(G/C) of JAZF1 gene, rs2069590(T/A) of BDKRB2 gene, rs5745709(G/A) of HGF gene, rs1991914(C/A) of OTOP1 gene and rs2236479(G/A) of COL18A1 gene, were typed with a custom-made Illumina GoldenGate Genotyping assay in 480 male patients with gout and 480 male controls. Potential association was assessed with the chi-square test. RESULTS No significant difference was detected for the 7 selected SNPs in terms of genotypic and allelic frequencies (P > 0.05). When age and body mass index (BMI) were adjusted, the 7 genetic variants still showed no significant association with gout. CONCLUSION The genotypes of the 7 selected SNPs are not associated with gout in ethnic Han Chinese male patients from the coastal region of Shandong province. However, the results need to be replicated in larger sets of patients collected from other regions and populations.
Adult
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Aged
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China
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ethnology
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Diabetes Mellitus, Type 2
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genetics
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Ethnic Groups
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Genetic Predisposition to Disease
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Gout
;
genetics
;
Humans
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Male
;
Middle Aged
;
Polymorphism, Single Nucleotide
10.Association of single nucleotide polymorphisms of cytochrome P450 gene with susceptibility to gout in ethnic Han males from coastal regions of Shandong province.
Lin HAN ; Guizhi MAO ; Ying CHEN ; Changgui LI ; Zhen LIU ; Yao WANG ; Xinde LI ; Mingxia SUN ; Wei REN ; Xuefeng WANG ; Zhaotong JIA
Chinese Journal of Medical Genetics 2015;32(4):538-542
OBJECTIVETo assess the association of cytochrome P450 gene single nucleotide polymorphisms (SNPs) with susceptibility to gout in ethnic Han males from coastal regions of Shandong province.
METHODSFour hundred and eighty male patients with gout and 480 healthy male controls were included. Genotyping was carried out with a custom Illumina GoldenGate Genotyping assay to detect SNP rs2275620 of CYP2C8 gene, SNP rs2070676 of CYP2E1 gene, SNP rs837395 of CYP4B1 gene, and SNP rs194150 of TBXAS1 gene. The association was assessed with chi-square test.
RESULTSNo significant difference has been found between the two groups in regard to the genotypic and allelic frequencies of the TT, AT, AA genotypes and A, T alleles of the SNP rs2275620 of the CYP2C8 gene (P=0.88; P=0.97), the CC, CG, GG genotypes and C,G alleles of SNP rs2070676 of the CYP2E1 gene (P=0.24; P=0.09), the TT, AT, AA genotypes and A, T alleles of SNP rs837395 of the CYP4B1 (P=0.88; P=0.97), and TT, AT, AA genotypes and the A,T alleles of SNP rs194150 of TBXAS1 gene (P=0.15; P=0.06).
CONCLUSIONThis study has identified no association of SNP loci rs2275620(A/T) of CYP2C8, rs2070676(C/G) of CYP2E1, rs837395(A/T) of CYP4B1 and rs194150(A/T) of TBXAS1 with gout in ethnic Han males from coastal regions in Shandong province. However, our result needs to be replicated in larger sets of patients collected from other regions and populations.
Adult ; Aryl Hydrocarbon Hydroxylases ; genetics ; Asian Continental Ancestry Group ; ethnology ; genetics ; China ; ethnology ; Cytochrome P-450 CYP2C8 ; genetics ; Cytochrome P-450 CYP2E1 ; genetics ; Disease Susceptibility ; Female ; Gout ; enzymology ; ethnology ; genetics ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Thromboxane-A Synthase ; genetics