Effect of triglycerides on gout flare and target achievement during initiation of urate-lowering therapy : A prospective cohort study
10.3760/cma.j.cn311282-20240412-00148
- VernacularTitle:三酰甘油对起始降尿酸治疗期间痛风发作及血尿酸达标率的影响：一项前瞻性队列研究
- Author:
Xiaohan WANG
1
;
Maichao LI
;
Changgui LI
;
Yuwei HE
Author Information
1. 青岛大学附属医院内分泌与代谢病科，青岛 266003
- Publication Type:Journal Article
- Keywords:
Gout;
Urate-lowering therapy;
Triglycerides;
Gout flare
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(12):1045-1051
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of triglycerides on gout flares and rate of achieving the target serum urate during the initial phase of urate-lowering therapy.Methods:In this prospective cohort study, male gout patients who visited the Gout Specialty Clinic of the Affiliated Hospital of Qingdao University from September 2021 to January 2024 were recruited. After a 2-week washout period with medication cessation and a low-purine diet, eligible participants were stratified into normal triglyceride group and hypertriglyceridemia group according to baseline triglyceride levels. All patients initiated uric acid-lowering therapy with febuxostat 20 mg once daily. For patients whose serum uric acid remained >360 μmol/L at 4 weeks, the dose was increased to 40 mg once daily. Follow-ups were conducted every 4 weeks for 12 weeks. Primary outcomes included gout flare frequency, serum uric acid target achievement rate, and changes in liver function.Results:A total of 557 gout patients were included in this study, including 266 in the normal triglyceride group and 291 in the hypertriglyceridemia group. During the initial phase of urate-lowering therapy, the rate(54.0% vs 44.4%, P=0.030) and frequency( P=0.028) of gout flares in the hypertriglyceridemia group were significantly higher compared with normal triglyceride group. Flare rate in the hypertriglyceridemia group was significantly higher(36.1% vs 25.2%, P=0.007) at week 0-4, but not during weeks 4-12.After urate-lowering therapy, the rate of achieving the target serum urate<360 μmol/L in hypertriglyceridemia group was significantly lower than normal triglyceride group(41.9% vs 52.6%, P=0.015). The incidence of alanine aminotransferase(ALT) or aspartate aminotransferase(AST) elevation greater than 2 times in hypertriglyceridemia group was significantly higher than that in normal triglyceride group(8.9% vs 2.6%, P=0.003). Conclusion:Hypertriglyceridemia significantly increases the risk of gout flares, reduces serum uric acid target achievement rates, and raises the likelihood of liver dysfunction during initial uric acid-lowering therapy in male gout patients.
